Handbook of Drug Administration Via Enteral Feeding Tubes Pdf, Epub, Ebook

HANDBOOK OF DRUG ADMINISTRATION VIA ENTERAL FEEDING TUBES PDF, EPUB, EBOOK

Adjustments in the medication dosage or frequency may be necessary when changing formulations. This may cause bloating, nausea, cramping, and diarrhea. Liquid medications, particularly elixirs and suspensions, are preferred for enteral administration; however, these formulations may be hypertonic or contain large amounts of sorbitol, and these properties increase the potential for adverse effects. Even simple and seemingly innocuous ingredients can cause problems when a drug is taken out of its capsule or a tablet is crushed, exposing the active ingredients before they reach the stomach and increasing the surface area available for drug interaction. Figure 2 provides an algorithm to guide enteral tube administration of medicines. Hosp Pharm. To minimize drug—nutrient interactions, special considerations should be taken when administering phenytoin, carbamazepine, warfarin, fluoroquinolones, and proton pump inhibitors via feeding tubes. Sign In. This rapid delivery method is commonly used when feeding into the stomach, and it is generally not well tolerated in patients with small bowel access; however, it offers the advantage of allowing medication administration to be separated from the feedings. Crit Care Med. In order to prevent feeding tube occlusions and to declog occluded tubes, the following steps should be taken to prepare an alkalinized enzyme solution 63 , 66 , 67 :. Aliment Pharmacol Ther. The feeding tube should be flushed with at least 5—10 mL of water between medications. Please check for further notifications by email. Therefore, if the feeding tube is placed in the small bowel, certain medications may have minimal benefit because the stomach is bypassed. The first 10 brief chapters provide background knowledge on the legal, practical and technical aspects of administering medications via an enteral feeding tube. However, dosage changes may be needed for an equivalent effect. The feeding tube placement site also affects drug absorption. Hospital Pharmacy. A useful summary of NICE guidance on the assessment and management of bipolar disorder in adults, children and young people in primary care. Preventing tube occlusions is preferable. Crushing phenytoin chewable tablets may be a possible option, too. Email alerts Article activity alert. London, UK: Pharmaceutical Press. Cite Cite Melissa Ranieri, B. This is a convenient and useful guide to have on the medical floor as a point of care reference for nurses, pharmacists, or any healthcare providers administering drugs via the enteral route or providing drug information. Hosp Pharmacist. Care should be taken not to administer the undissolved gelatin portion into the tube because this may cause occlusion. Restoring and maintaining patency of enteral feeding tubes 5. Dosage formulations should be carefully selected and appropriately prepared for administration via the enteral feeding tube. Medications with carcinogenic, teratogenic, or cytotoxic properties should also not be crushed. This is a practical book which contains more detail on drug administration via enteral tubes than is readily available elsewhere. Dissolve powder mixture in 5 mL of warm water. The administration of proton pump inhibitors via feeding tubes presents a unique challenge. In addition to flushing enteral feeding catheters with water before and after drug delivery, diluting liquid medications, particularly those that are highly concentrated or viscous, is also important. Topics covered include the key responsibilities of pharmacists; the different types, sizes, and positions for feeding tubes; the importance of tube patency; techniques for flushing, restoring, and maintaining tube patency; and the advantages and disadvantages for each medication formulation. These medications include antacids, which neutralize stomach acid, as well as sucralfate and bismuth, which both form a protective barrier in the stomach. The warfarin dose may need to be increased, or a switch to another anticoagulant, such as a low-molecular-weight heparin, may be necessary. Receive exclusive offers and updates from Oxford Academic. Warfarin resistance and enteral feedings: 2 case reports and a supporting in vitro study. Handbook of Drug Administration Via Enteral Feeding Tubes Writer

Delivery of omeprazole and lansoprazole granules through a nasogastric tube in vitro. Healy et al. Medicine administration errors in patients with dysphagia in secondary care: a multi-centre observational study. Biosimilar formulary placement in Medicare Part D prescription drug plans: A case study of infliximab. Skip to content. Purpose: The monographs are intended to support healthcare practitioners in making decisions on the safe and effective administration of medications through enteral feeding tubes. A useful summary of NICE guidance on the assessment and management of bipolar disorder in adults, children and young people in primary care. Another beneficial effect includes improved maintenance of GI mucosal structure and function, which could possibly prevent gut atrophy and bacterial translocation. Medication incidents related to feeding tube: A cross-sectional study. Flushing enteral feeding tubes 4. Download a PDF of the algorithm for administration of drugs via enteral feeding tubes. Dickerson RN, Melnik G. Various volumes of water have been suggested for drug dilution, which include 10—30 mL and up to 60—90 mL. Europe PMC requires Javascript to function effectively. J Pain Symptom Manage. Your comment will be reviewed and published at the journal's discretion. AcipHex rabeprazole package insert. Warfarin resistance and enteral feedings: 2 case reports and a supporting in vitro study. Determine the enteral feeding tube size e. Home Australian Prescriber Handbook of drug administration via enteral feeding tubes. Medications should not be directly mixed with the enteral feeding formulas. Syringes and ports Enteral feeding tubes are increasingly used to administer medications in the acute care, community care, and long-term care settings for patients receiving nutritional support. Additionally, when certain medications that are characterized by extensive first-pass hepatic metabolism e. External link. Several medications interact with EN, and patients should be monitored for altered clinical response or subtherapeutic drug levels. In fact, acidic liquids, such as cranberry juice and colas, may even worsen the problem by precipitating protein in the enteral formulas. Patients with long-term conditions requiring feeding tubes are frequently managed in the community and looked after by primary care clinicians. BNF for Children. Evaluating knowledge, attitude and practice of intensive care unit nurses in administering medications via enteral tubes. View 3 excerpts, cites background. See details. Information is provided on sites of oral absorption, alternative routes, interactions with food and enteral feeds, health and safety precautions, altering available products, and intragastric and intrajejunal administration procedures. These feeding tubes may be inserted nasally, with the distal end of the tube in the stomach nasogastric [NG] or in the small intestine nasoduodenal [ND] or nasojejunal [NJ]. Riss et al. In vitro evaluation of nasogastric administration methods for phenytoin. Administration of liquid-filled soft gelatin capsules is more challenging. Choice of medication formulation 7. Enteral nutrition implementation and management. Close mobile search navigation Article Navigation. Most medicines are not licensed or designed for administration via enteral tubes and, therefore, evidence to support delivery via this route is frequently limited and guidance is based on best practice. Enteral nutrition and drug administration, interactions, and complications. It is also less likely to cause tube occlusions. Readers need to be aware that there are some differences in the brand names as well as formulations and strengths available in the United Kingdom compared to the United States such as paracetamol [acetaminophen] infusion and zinc sulphate effervescent tablets. NG tubes are also available in a larger diameter e. Forgot password? This is a convenient and useful guide to have on the medical floor as a point of care reference for nurses, pharmacists, or any healthcare providers Load more articles. Rebecca White , Vicky Bradnam. Once-daily drug dosing and intermittent or bolus feedings are easier to work with than multiple-daily drug dosing and continuous feeding regimens. Handbook of Drug Administration Via Enteral Feeding Tubes Reviews

Search ADS. About Australian Prescriber Contact us. Since the enteral route is increasingly used as a means of medication administration, health care providers need to be cognizant of the potential complications and limitations associated with this method of drug delivery. Phenytoin and enteral feedings: does evidence support an interaction? Pantoprazole is available as an enteric-coated tablet and a new delayed-release oral suspension. In fact, acidic liquids, such as cranberry juice and colas, may even worsen the problem by precipitating protein in the enteral formulas. Various enteral feeding tubes are available for delivering medications and nutrients to the patient. Article Contents. Subsequently, the enteral products were reformulated to reduce the vitamin K content. Alternatively, the entire soft gelatin capsule may be dissolved in a container of warm water and all of the contents given. Search Menu. Riss et al. These medications are not designed for absorption in the GI tract, and crushing them for administration via the enteral tube may result in reduced drug absorption and lack of efficacy. Oxford Academic. It is written for any healthcare practitioner who is involved in administering drug to patients with limited GI access, such as nurses, nursing students, physicians, dietitians in hospitals, and pharmacists. Health and safety and clinical risk management 9. A user friendly, single point of reference for healthcare professionals in the safe and effective Like continuous administration, this delivery method may be used when feeding into the stomach or small intestine. Find drug information fast on our extensive range of databases. Advanced Search. When delivering any medication through an enteral access device, the appropriate flushing technique is essential to reduce the risk of tube occlusion and to maintain patency. BNF for Children. Clin Ther. Managing drug therapy in patients receiving enteral and parenteral nutrition. A tube inserted through the mouth into the stomach orogastric [OG] is another option for short-term feeding, particularly when a tube cannot be placed nasally because of head injury or sinusitis. Role of early enteral feeding and acute starvation on postburn bacterial translocation and host defense: prospective, randomized trials. A randomized, pharmacokinetic and pharmacodynamic, cross-over study of duodenal or jejunal administration compared to nasogastric administration of omeprazole suspension in patients at risk for stress ulcers. This results in an activated pancrelipase pH 7. It may be necessary to change the medication to a therapeutically equivalent agent that does not contain sorbitol or an agent that has a lower osmolality. Two important things to consider when administering medications through a feeding tube include the tube size and placement site. The authors of the Handbook of Drug Administration via Enteral Feeding Tubes achieve their aim of supporting healthcare professionals in the safe and effective prescribing of drugs via enteral feeding tubes. The tubes are typically classified by site of insertion e. The stomach is also able to tolerate various medications and enteral formulas, including hypertonic preparations. The handbook would be useful to nurses, pharmacists, doctors and dietitians who regularly deal with patients on enteral feeds. Enteric-coated products are one example because they should not be crushed. The monographs list UK formulations and relevant data for each drug. The average osmolality values of other liquid preparations have been published elsewhere. Unfortunately, there are limited medications available via transdermal delivery, and the sublingual and buccal routes may be inappropriate options because of mouth injuries, decreased mental status, dry mouth, excessive salivation, or vomiting.

Handbook of Drug Administration Via Enteral Feeding Tubes Read Online

Am J Crit Care. Interference of oral phenytoin absorption by continuous nasogastric feedings. Save to Library. Although it may be convenient to mix drugs with enteral feedings, this practice can result in physical incompatibilities, decreased drug absorption, increased risk of tube occlusions, and potential microbial contamination. Although suspensions may have a high osmolality, diluting with water will help decrease the tonicity. Audience: The book is intended to help healthcare professionals make decisions regarding which medications are safe to administer via enteral feeding tubes, which tubes are appropriate to administer the drugs, and how to do so. The enteric coating allows for medication to be released in the small intestine rather than the stomach. Enteric-coated products are one example because they should not be crushed. View Metrics. This may cause bloating, nausea, cramping, and diarrhea. Sorry, this item can only be purchased by current members. Comments 0. Due to ongoing disruption with supply chains, if you are unable to place a bulk order for our printed pharmaceutical books and products through your normal channels we can help. All rights reserved. Provides technical, practical and legal aspects that should be considered before prescribing or administering drugs via enteral feeding tubes. Sorbitol content may also differ among manufacturers of a particular product. Various medications may cause drug—formula incompatibilities and result in tube occlusions. Email alerts Article activity alert. The best way to determine the sorbitol content of a liquid medication is to contact the drug manufacturer. The bioavailability of this antibiotic class may be reduced when given with multivalent cations such as calcium, magnesium, aluminum, and iron. Arch Phys Med Rehabil. Need Help? It dissolves on the tongue or may be mixed with a small amount of water in an oral syringe and injected through the NG tube. Toggle navigation 0. Google Scholar. However, several issues must be considered with concurrent administration of oral medications and enteral formulas.

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