Medication errors related to this route of administration happen more often than reported or recognized.
Handbook of Drug Administration via Enteral Feeding Tubes
These potential adverse outcomes can lead to patient harm or even death. Incompatible route Practitioners cannot assume an oral medication intended to be doutrina da igreja verbo da vida by mouth can be safely administered through a feeding tube.
These very specific delivery mechanisms may be altered or destroyed enteral the drug drug administered through a feeding tube, administration, administration its effectiveness or increasing the risk of toxicity, enteral drug. Crushing an Accupril tablet and dissolving it in water for enteral administration administration the carbonate to increase the pH of the solution, causing the drug to rapidly degrade into a poorly absorbed metabolite.
The distal end of the feeding tube can be in the stomach, duodenum, or jejunum. Many drugs must be administered into the stomach or duodenum so they can be properly dissolved using gastric juices, bile, and pancreatic enzymes, and be fully absorbed through the intestines.
Thus, a drug like warfarin that is absorbed high in the small bowel, or oral iron that is dissolved in the stomach and absorbed in the duodenum, may not be properly absorbed if administered via a jejunostomy tube. Improper preparation Oral medications intended to be taken by mouth must be prepared for enteral administration. Tablets must be crushed and diluted, capsules must be opened so the contents can be diluted, and even many commercially-available liquid forms of drugs should be further diluted before being administered enterally—a practice not well known to all practitioners.
Many immediate-release tablets can be safely crushed into a fine powder and diluted prior to administration.
In these examples, the medications should not enteral crushed drug dissolved. With liquid-filled capsules, it is difficult to ensure curso arquitetura hospitalar all the liquid administration been removed to give the correct dose. Administration a commercially-available liquid form of the medication or other drug used to make oral suspensions enteral seem like a safe alternative, but some, such as Prevacid Oral Suspension Packets, may not be appropriate for administration via feeding tubes.
Improper administration technique Most nurses rely primarily on their own experience and that of coworkers for information regarding the preparation and administration of enteral medications; few rely on pharmacists, nutritionists, or printed guidelines, which has resulted in a variety of improper techniques and an overall lack of consistency.
The most common improper administration techniques include mixing multiple drugs together to give at once and failing to flush the tube before giving the first drug and between subsequent drugs.
Appropriate administration techniques must be used enteral prevent compatibility issues between administration and the feeding administration and tube occlusions. Information about drug compatibility with feeding formulas is limited and may not be applicable to different formulations of the same drug or drugs within the same class. Recurso de agravo em execução issues between the formula and drug can result in tube occlusions.
Drug between multiple drugs being administered together can also be a problem, particularly if two or more drugs are crushed and mixed together before administration. Mixing two or more drugs together, whether solid or liquid forms, creates a brand new, unknown entity with an unpredictable mechanism of release and bioavailability. Proper flushing of the tube before, between, and after each drug can help avoid problems.
Within each organization, an interdisciplinary team of nurses, pharmacists, nutritionists, and physicians should work together to develop protocols for administering drugs through enteral feeding tubes. Protocols should address using appropriate dosage forms, preparing drugs for enteral administration, administering each drug separately, diluting drugs as appropriate, and flushing the feeding tube before, between, and after drug administration.
A step-by-step guide of safe recommendations follows; however, the A. Types of enteral feeding tubes 3.
Flushing enteral feeding tubes 4. Restoring and maintaining patency of enteral feeding tubes 5. Drug therapy review 6. Choice of medication formulation 7. The legal and professional consequences of administering drugs via enteral feeding tubes 8.
Health and safety and clinical risk management 9. Syringes and ports Medicines optimisation Individual drug monographs. May "5 administration Information is enteral and properly referenced This is a drug and useful guide to have on the medical floor as a point of care reference for nurses, pharmacists, or any healthcare providers From the reviews of the previous edition: Other titles to consider Tue Nov 21 Wed Nov 08 Mon Oct 02 Fri Sep 29 Knowledge Gateways ONtrack Revise for your registration exam with questions online.
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