Friday, January 22, 2016

Oral Antihypertensives Via Ryle's Tube

Medications
Comments
Amlodipine
·      Disperses in water. Give immediately as light-sensitive
Atenolol
·      Liquid preparation is available
Bisoprolol
·      Crush tablet and disperse in water.
Captopril
·      Tablets disperse in 10ml water in 2 minutes to give suspension (2)
Carvedilol
·      Crush and disperse in water
Diltiazem
·      Capsules may be opened and granules administered without crushing
Enalapril
·      Disperse slowly in water with stirring
Felodipine
·      DO NOT CRUSH as will lose sustained release properties
Frusemide
·      Has liquid preparations
Hydralazine
·      Crush and disperse in water. May be increased rate of absorption so monitor blood pressure
Irbesartan
·      Crush and disperse tablet in water
Lisinopril
·      Tablets slowly disperses in water
Losartan
·      Crush and can mix with 10ml of water to form fine suspension (2)
Metoprolol
·      Disperses slowly in water. Consider change to atenolol liquid preparation
Methyldopa
·      Suspension available(2)
·      Tablet will disperse in >2minutes (3)
Nifedipine
·      Can be given through Ryle’s tube***
Perindopril
·      Crush and disperse tablet in water
Prazosin
·      Can crush. Insoluble so ensure wash down with water (2)
Propranolol
·      Liquid preparation maybe available
Telmisartan
·      Can crush. Not very soluble but will flush via 8Fr NG tube without blockage. To be given immediately as it absorbs moisture once crushed. (2)
Valsartan
·      Open capsules and give contents in water immediately as it is not very stable
Verapamil
·      Liquid preparation 
·      Tablets will disperse in >2minutes (3)
***Full explanation is in guideline from reference source no 1.
REFERENCE
  1. http://www.cddft.nhs.uk/media/183967
  2. MEDICATION ADMINISTRATION IN PATIENTS WITH SWALLOWING DIFFICULTIES/DYSPHAGIA
  3. NEEMMC GUIDELINES FOR TABLET CRUSHING AND ADMINISTRATION VIA ENTERAL FEEDING TUBES, http://www.stch.org.uk/

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