Improving Oral Medicine Administration in Patients with Swallowing Problems and Feeding Tubes

Patients with swallowing problems and feeding tubesprovide pharmaceutical challenges for administration of medications usually delivered by the oral route.1,2 Dur-ing the past 2 decades, modified-release formulations have been developed to simplify dosage regimens and improve adherence. These sophisticated formulations often cannot be cut or crushed and are therefore usually unsuitable for patients with swallowing problems and feeding tubes. For example, the coating or tablet matrix may be difficult to crush and may block the tube, or the drug’s release charac-teristics may be unpredictably altered, leading to subthera-peutic doses or rapid release of high doses. One option in patients unable to swallow is to prepare liquid formula-tions, ensuring that any possible interactions with the food or administration tubing are taken into consideration.1 Several authors and organizations have issued excellent guidelines and educational charts emphasizing the correct practice and providing plenty of rationale for doing so.3-7 This information may not be readily available, and nurses may not be adequately trained in the selection of the cor-rect formulation and how to prepare it for administration