Solid oral medications' suitability for use in enteral feeding tubes

2021 ◽  
Author(s):  
Kersti Teder ◽  
Liisa Jõhvik ◽  
Andres Meos ◽  
Marika Saar ◽  
Alesya Visbek ◽  
...  
Keyword(s):  
Enteral Feeding ◽  
Feeding Tubes ◽  
Oral Medications

scholarly journals Off-label use of drugs administered by enteral feeding tubes in an Intensive Care Unit in Fortaleza, Brazil

2021 ◽  
Vol 12 (1) ◽  
pp. 562
Author(s):  
Gabriela A. ABREU ◽  
Elana F. CHAVES ◽  
José A. NETO ◽  
Lívia P. MOREIRA ◽  
Johann V. SILVA ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiovascular System ◽  
Enteral Feeding ◽  
University Hospital ◽  
Adult Intensive Care Unit ◽  
Feeding Tubes ◽  
Oral Medications ◽  
Oral Formulations ◽  
Administration Methods

Objective: To analyze the prescription profile of drugs administered through enteral feeding tubes in an adult intensive care unit and gather recommendations for their safe administration. Methods: This is a descriptive and retrospective study conducted with adult critical clinical patients of a university hospital in Fortaleza-Ceará from March to May 2018. We performed analyses of patients’ medical records and prescriptions regarding drugs, pharmaceutical presentations and the possibility of administration through enteral tubes. Results: 489 prescriptions containing 1914 items were evaluated, from which 16.6% (n = 318) through tubes. Medicines for the cardiovascular system (34.6%), nervous system (27.4%) and digestive system and metabolism (15.1%) were the most predominant, with an average of 5.8 (DP: 4.2) different per patient. Regarding the pharmaceutical presentation, oral solids were frequently prescribed via enteral tube (67.9%), especially risperidone (8.8%), carvedilol (8.3%) and amiodarone (7.9%). There were contraindications for administration through tubes in 21.6% of solid oral formulations, while there were alternative standardized pharmaceutical forms in the hospital for 43.1%. In addition, substitution for liquid preparations from the market were possible in 43.1%. Among those to which there were no alternative formulations, drugs targeting the cardiovascular system prevailed (52.2%). A table with guidelines for the proper administration of the prescribed solid medications was elaborated then. Conclusion: Solid oral medications were frequently prescribed through enteral tubes, especially those for the cardiovascular system without alternative formulations, which shows the need for guidelines to promote the safety of this process.

scholarly journals Preparing and administering medications via enteral feeding tubes: a guideline for clinical pharmacists and multi-professional team

2021 ◽  
Vol 12 (2) ◽  
pp. 600
Author(s):  
Danyara BATISTA ◽  
Paula M. OLIVEIRA-LEMOS
Keyword(s):  
Enteral Feeding ◽  
Public Hospital ◽  
Feeding Tube ◽  
Cross Sectional Study ◽  
Second Step ◽  
Cross Sectional ◽  
Feeding Tubes ◽  
Enteral Feeding Tube ◽  
Oral Medications ◽  
Pharmaceutical Form

Objective: To identify the most prescribed drugs by enteral feeding tube in a public hospital and to a guideline for safe medication preparation and administration via enteral feeding tubes. Methods: A cross-sectional study with analysis of the daily prescriptions of patients exclusively using an enteral catheter in intensive care units and inpatients of the medical clinic specialty, in which descriptive statistics were used to identify the prevalence of medication use by tube. In a second step, a protocol was developed for the situation in which oral medications are prescribed to patients with a tube in the digestive tract. Results: A total of 1.810 medications prescribed by enteral feeding tube, of these 1.810, 291 (16%) were prescribed in liquid pharmaceutical form (suspension, solution, syrup) e 1.519 (84%) were prescribed in solid pharmaceutical form (tablets, capsule). 52 medications were selected for the protocol, and 14 of them (26.9%) with the recommendation of not crushing and administering via enteral feeding tube. Conclusion: Our results highlights the performance of clinical pharmacist in monitoring patients with enteral feeding tubes and guidance of multi-professional team. The protocol elaboration will guide for preparation and administration medication through the enteral feeding tube, reducing possible adverse events and ensuring the safety and efficacy of drug therapy.  

scholarly journals Medication Administration through Enteral Feeding Tubes in Mechanically Ventilated Critically Ill Patients: Evaluation of the Potential Medication Errors

2020 ◽  
Author(s):  
Mandana Izadpanah ◽  
Negin Amraie ◽  
Farhad Soltani ◽  
Leila Kouti ◽  
Sepideh Sayyadi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Medication Errors ◽  
Enteral Feeding ◽  
Critically Ill Patients ◽  
Medication Administration ◽  
Oral Medication ◽  
Drug Preparation ◽  
Mechanically Ventilated ◽  
Feeding Tubes ◽  
Oral Medications

Background: Oral medication administration through enteral feeding tubes is a challenging issue in critically ill patients, which can lead to medication error. Patients admitted to the intensive care unit may not have the ability to swallow oral medications for various reasons such as lack of consciousness, or the need for mechanical ventilation. Improving the quality of drug administration through enteral feeding tubes is essential. The present study aimed at evaluation of the prevalence of medication errors that occur during the administration of oral medications through enteral feeding tubes in mechanically ventilated critically ill patients. Methods: This study was a cross-sectional observational study conducted in Golestan Educational Hospital, Ahvaz, Iran. Oral medication administration was evaluated in 50 patients within three months; demographic information, medical records and medicine prescribing information about each patient was examined. The errors were measured according to the Handbook of Drugs Administration via enteral feeding tubes. Results: Errors occurred in percentage of total prescriptions as follows: Drug-drug interaction 26%, wrong preparation 22.3%, incorrect dosage form 12.1%, wrong time error 11.6%, drug-food interaction 6.7%, improper dose error 5.5%, wrong route 3.8%, extra dose 0.9%, omission 0.2%, deteriorated drug 0.2%, and unordered drug 0.0%. In our study, it was found that most of the drugs were administered in solid dosage forms, and almost 33% of them could be substituted for injection or oral liquid formulations. Conclusion: Our study indicated the high frequency of drug preparation errors in mechanically ventilated critically ill patients. Close teamwork between pharmacists or pharmacotherapists, physicians, and nurses can result in the appropriate administration of medications by an enteral feeding tube. J Pharm Care 2019; 7(3): 52-56

Enteral Feeding Tubes

2002 ◽  
pp. 103-114
Author(s):  
David E. Ciccolella
Keyword(s):  
Enteral Feeding ◽  
Feeding Tubes

Group IV: Enteral Feeding Tubes: What is Available and What is Needed?

1997 ◽  
Vol 12 (1) ◽  
pp. S60-S60
Author(s):  
Melanie Horbal Shuster ◽  
Keith E. Georgeson ◽  
Matthew S. Johnson ◽  
Howard Levy ◽  
Moshe Shike
Keyword(s):  
Enteral Feeding ◽  
Group Iv ◽  
Feeding Tubes

scholarly journals Manipulations of Oral Medications in Paediatric Neurology and Oncology Care at a Swedish University Hospital: Health Professionals’ Attitudes and Sources of Information

Pharmaceutics ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1676
Author(s):  
Rania Kader ◽  
Gunnar Liminga ◽  
Gustaf Ljungman ◽  
Mattias Paulsson
Keyword(s):  
Enteral Feeding ◽  
Product Information ◽  
Feeding Tube ◽  
Paediatric Oncology ◽  
Working Environment ◽  
University Hospital ◽  
Hazardous Substances ◽  
Oral Dosage ◽  
Sources Of Information ◽  
Oral Medications

Oral administration of medications to children requires age-appropriate dosage forms and strengths. In this study, we: (i) assessed the extent of oral dosage form manipulations, (ii) documented how it is carried out, and (iii) examined the attitudes and sources of information regarding the handling from healthcare professionals. Prospective reviews of electronic records, ward observations, and clinician surveys were performed at a paediatric neurology ward and a paediatric oncology ward in Sweden during April to May of 2018. Approximately 15% of oral medications were manipulated for the studied patient group (median age 12.9 years in oncology, 5.8 years in neurology) with approximately 30% of the patients having an enteral feeding tube. Manipulations were performed both to obtain an appropriate dose from, for example, a fraction of the original tablet or to obtain a powder that could be used to prepare a slurry for administration through enteral feeding tubes. Risks identified were related to patient safety such as cross contamination, suboptimal absorption/pharmacokinetics and inaccurate dose. When examining the working environment of nurses, we observed safe handling of hazardous substances but the nurses occasionally experienced stress and a fear of making mistakes due to absence of information. Paediatricians experienced a lack of time to search for proper information on manipulations. As a step towards improving safety in paediatric medication, we suggest the introduction of clinical pharmacists into the team and further evaluating the possibilities of using more ready-to-administer medications with necessary product information and pharmacovigilance support.

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