[Alternatives to solid pharmacutical forms usually given by enteral nutrition tubes]

Area of Science:

• Pharmaceutical Sciences
• Clinical Pharmacy
• Patient Safety

Background:

• Enteral nutrition (EN) tubes are crucial for patients unable to take oral medications.
• Administration of medications through EN tubes can lead to drug-related problems due to pharmaceutical formulation.
• Limited information exists regarding safe medication administration practices via feeding tubes.

Purpose of the Study:

• To identify medications administered via EN tubes that present formulation-related administration issues.
• To propose alternative pharmaceutical forms or administration methods for problematic drugs.
• To emphasize the need for improved hospital pharmaceutical guidelines and ward-level education.

Main Methods:

• Analysis of 48 different medications administered to 40 patients with feeding tubes.
• Categorization of medications by pharmaceutical form (solid vs. liquid).
• Identification of specific drugs with contraindications when administered in solid form via EN tubes.

Main Results:

• 78.3% of medications were solid forms, 21.7% were liquid.
• Commonly administered drugs included ranitidine, paracetamol, and phenytoin.
• Solid forms of phenytoin, nifedipine, and controlled-release morphine were identified as problematic.

Conclusions:

• Solid pharmaceutical forms of certain drugs pose significant risks when administered through enteral nutrition tubes.
• Development and availability of liquid formulations for drugs that cannot be crushed is essential.
• Enhanced hospital pharmaceutical guides and increased staff education are necessary to ensure safe medication practices via EN tubes.