Drugs via nasogastric tubes.
Article Type: Brief article
Subject: Drugs (Dosage and administration)
Drugs (Methods)
Drugs (Complications and side effects)
Pub Date: 03/01/2009
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
Accession Number: 204550668
Full Text: 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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