The survey included a series of questions aimed at learning the patients level of knowledge regarding which drugs can be split or crushed In order to collect the list of medications several databases were consulted Results Of the study group % had crushed or split a tablet prior to its administration most of them to facilitate oral
Table 1 Common Medications That Should Not Be Crushed Generic Name Brand Name Dosage Form Sustained release Medications Aspirin/Dipyridamole Aggrenox Tablet Bupropion Wellbutrin SR XL Zyban Tablet Furthermore the pellets inside microencapsulated medications can be flushed down an EFT following dilution as long as they are not crushed
Tablets may be crushed and mixed in 100 ml of water grape or orange juice; Powder should be mixed with 2 4 oz of soft food and swallowed immediately; Do not mix powder with liquids Zidovudine [2] ZDV / Retrovir No Yes IV Add to small amount of semi solid food or liquid; consume immediately Non Nucleoside Reverse Transcriptase Inhibitors
Can crush Wear a mask and gloves if crushing4 CITALOPRAM PSM Citalopram Tablet Film coated3 Disperse the tablet in water may take up to 10min to disperse4 CLINDAMYCIN Dalacin C Capsule Can disperse capsule contents in 10ml of water but has an unpleasant taste; can mix with food or juice to mask taste4 Alternative route available7
Always consult with pharmacy if you are not 100% sure if a medication can be crushed Also look at the name of the drug for certain letters For example Detrol LA or Toprol XL are both long acting medications that can t be crushed If possible consult with the physician or pharmacists on switching medications to liquid form or IV form
Mixing crushed medication with foods juices or thickeners may alter a medication s bioavailability introducing risk of variable or incomplete dosing Pill swallowing gels are registered medical devices suitable for use in healthcare settings as well as by patients at home Mouth sprays and pill coatings are best suited for at home use
Can the patient still take their medicines orally • Liquid preparations are often available • Some tablets can be crushed and some capsules can be opened and administered orally with water Do not crush modified release MR or enteric coated EC preparations or pierce soft gel capsules Review all medication
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Consider switching to an immediate release formulation that can be crushed if possible Tablet coating Enteric coated tablets they might have names that include EC are not suitable for crushing Film coated tablets can be difficult to crush and once crushed may have an unpleasant taste or anaesthetic effect on the tongue
The nurse should explain that which of the following medications can be crushed Extended release oxycodone Sublingual nitroglycerine Enteric coated aspirin Sucralfate tablets The nurse needs to include a list of all medications that the client takes both prescribed and OTC Medication reconciliation can identify potential interactions
Not all medication can be crushed for consumption Crushing pills for easy consumption can be dangerous as it can alter the absorption and stability of the medication resulting in a higher risk of gastric irritation At times crushing medication inappropriately can even lead
Some medications may cause oesophageal or stomach irritation or ulceration if tablets are crushed or capsules opened nitrofurantoin potassium chloride alendronate diclofenac Bitter Tasting Drugs For drugs which have a particularly bitter taste a coating sugar/film is often used to help mask
Oral medication that should NOT be crushed or opened Drug delivery systems have become increasingly complex Some tablets and capsules may have special coatings for example sugar coating film coating or enteric coating These coatings are designed to modify the rate that the drug is released into the body
medication administration Prevents/minimises blockages of tubes Causes of blockages Interaction b/w feeds and medication Viscosity of liquid medication Binding of medication to the tube Residue of tablet that has been crushed Minimum volume to flush is 2ml Maximum volume depends…
Still it s important to remember that not all medications can be crushed especially enteric coated pills sustained release pills and opioid drugs If you can crush a pill use a recommended method like a pill crusher or a mortar and pestle to grind the pill to a fine powder Ask your healthcare provider or pharmacist how you should take
Page 2 of 16 Drug Product Active Ingredient s 2 Dosage Form s Reasons/Comments3 Aplenzin buPROPion Tablet Extended‐release Apriso mesalamine Capsule Extended‐release a Note maintain pH at less than or equal to Aptivus tipranavir Capsule Note oil emulsion within spheres; taste Aquatab C combination Tablet Slow‐release h
of medication or water Give medication via enteral tube as directed by the guidance within the table If more than one medicine is being administered flush with at least 10mL of water between each medication After administration of the last medication flush tube well with 15 30mL of water after the dose
The survey included a series of questions aimed at learning the patients level of knowledge regarding which drugs can be split or crushed In order to collect the list of medications several databases were consulted the injectable form of the medication can be used by placing the appropriate amount of medication in a liquid as a juice
Page 1 of 15 Oral Dosage Forms That Should Not Be Crushed John F Mitchell PharmD FASHP1 Last updated October 2012 Drug Product Active Ingredient s 2 Dosage Form s Reasons/Comments3 AcipHex RABEprazole Tablet Extended‐release Actiq fentaNYL Lozenge Slow‐release Note this lollipop delivery system requires the
Activity is based on recent site visitor activity relative to other medications in the list Rx Prescription only OTC Over the counter Rx/OTC Prescription or Over the counter Off label This medication may not be approved by the FDA for the treatment of this condition EUA
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It is important to note that while we have compiled a list of over 500 medications that should not be crushed it is crucial to understand that it does not include every single drug that cannot be crushed available on the market Our list is intended to be a useful guide for individuals who may require such information
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