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Gastrostomy

Gastrostomy . Medication Management By Clare Shalders 2007. Gastrostomy tube. Gastrostomy Tubes. Enteral feeding is a method of maintaining Hydration and nutrition for residents who suffer from an illness that affects the ability to take an adequate intake to maintain nutritional status

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Gastrostomy

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  1. Gastrostomy Medication Management By Clare Shalders 2007 GOTAFE/CSHALDERS2009

  2. Gastrostomy tube GOTAFE/CSHALDERS2009

  3. Gastrostomy Tubes • Enteral feeding is a method of maintaining Hydration and nutrition for residents who suffer from an illness that affects the ability to take an adequate intake to maintain nutritional status • A feeding tube is passed directly into the stomach or small bowel and liquid nutrition is provided GOTAFE/CSHALDERS2009

  4. Administering medications • Goal • Maximise the therapeutic effect of a medication without adversely effecting the delivery of the enteral feed • Administration can be problematic GOTAFE/CSHALDERS2009

  5. Administering Medications • Altering the form of the medication can interfere with the drug’s efficiency i.e. crushing • Changes may occur in the absorption, distribution, metabolism or excretion of altered medications • Physical changes can occur and risk peg tube occlusion GOTAFE/CSHALDERS2009

  6. Medication Forms • Liquid medication is the best option as there is decreased risk of tube occlusion and increased absorption of the medication • Certain preparations may cause GI distress, especially those with high osmolarity • Complications can be minimised by diluting liquid medications in 30 ml of water GOTAFE/CSHALDERS2009

  7. Medication Forms • Immediate release oral tablets: tablets should be crushed finely and mixed with 10-30ml of water • Soft gelatine capsules: prick the capsule and squeeze out the contents GOTAFE/CSHALDERS2009

  8. Medications not for administration • Enteric coated administration; enteric coating protects the integrity of the medication from destruction by the stomach acid and therefore crushing the medication reduces it’s effectiveness GOTAFE/CSHALDERS2009

  9. Medications not for administration • Sustained release medications: altering the form of the sustained release medications changes the medication properties • Sublingual medications GOTAFE/CSHALDERS2009

  10. Medications not for administration • Acidic liquid medications: many syrup medications are too acidic for administration via the gastrostomy tube • Elixir and suspension liquids should be used rather than syrups GOTAFE/CSHALDERS2009

  11. Minimise complications • Use liquid medications first priority • Prepare medication forms as described • Consider the timing of the medication administration in relation to enteral feed • Verify the position of the gastrostomy tube before administering medication GOTAFE/CSHALDERS2009

  12. Minimise complications • Use the medication port on the gastrostomy tube to administer medications • Use a syringe size greater than 30 mls as smaller syringes create to much pressure • Do not mix medications with enteral feeds • Be careful of drug incompatibilities • Flush the gastrostomy tube with 30 mls of water before and after medication administration • Flush with 15mls of water in between different medication GOTAFE/CSHALDERS2009

  13. References • Ref. http://nwmdgp.org.au/pages/after-hours/GPRAC-CIS_07.html • Bullock, S. Manias,E. Galbraith, A. Fundamentals of Pharmocology. 5th Edition.Pearson Education Australia. 2007 GOTAFE/CSHALDERS2009

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