Medication Lost During Administration of Crushed Pills

For patients requiring oral medications but unable to swallow, common nursing practice is to crush the pill, suspend it in water, and administer it via syringe through a gastric tube. Nurses have observed residue left during this process, potentially affecting prescribed dosage.

To quantify aspirin lost during administration of a crushed pill.

Nurse researchers partnered with a university chemistry laboratory for this study. A 325-mg aspirin tablet was crushed in a plastic sleeve with a pill crusher, tapped into a medication cup, suspended in water, and injected through a gastric tube into a flask; the tube was then rinsed with additional water. This slurry was dissolved in 100 mL isopropyl alcohol, diluted to 1 L with deionized water, and analyzed with ultraviolet-visible spectroscopy. Light absorbance at 231 nm was compared with a known solution to measure how much aspirin reached the flask. This process was repeated 5 times. Calculations based on data from these experiments quantified aspirin lost during crushing, suspending, and delivering the aspirin to a flask.

For the 5 trials, a mean (SD) of 22.0% (3.1%) of aspirin was lost during the process of crushed pill administration. A mean (SD) of 5.7% (2.7%) was lost in the sleeve and cup, and the remainder was lost between the syringe and the final collection flask.

Quantifying medication loss during the practice of crushing pills for delivery via gastric tube has implications for medication administration.