Drugs via nasogastric tubes.
|Article Type:||Brief article|
(Dosage and administration)
Drugs (Complications and side effects)
|Publication:||Name: South African Medical Journal Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 South African Medical Association ISSN: 0256-9574|
|Issue:||Date: March, 2009 Source Volume: 99 Source Issue: 3|
|Geographic:||Geographic Scope: South Africa Geographic Code: 6SOUT South Africa|
Crushing tablets and opening capsules before administering via
nasogastric tubes is a widespread practice. Eric Decloedt and Gary
Maartens (4) highlight the problems associated with administering drugs
via this route. They note that patients may be harmed if the
bioavailability of drugs is either impaired, resulting in reduced
efficacy, or enhanced, resulting in toxicity. Mechanical failure of
nasogastric tubes may occur as a consequence of administering drugs.
There are also important medico-legal implications of administering
altered oral drug formulations (drugs are registered to be administered
as particular formulations, and altering the formulation before
administration renders their use off-label).
Examples are crushing of enteric-coated tablets that protect the active ingredient against degradation by gastric acid, which would reduce bioavailability; and reduction of serum concentrations of phenytoin by 72% when it is administered with enteral feeds. Crushing different medications in the same receptacle should be avoided owing to possible drug interactions.
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(4.) Decloedt E, Maartens G. Pitfalls of administering drugs via nasogastric tubes. S Afr Med J 2009; 99: 148-149.
|Gale Copyright:||Copyright 2009 Gale, Cengage Learning. All rights reserved.|