Clipping Board » Drug Poisoning ─ It is necessary to be aware of the toxic side effects before taking medication.
10/16/2012 [Taiwan New Life News / Reporter Zhong Peifang / Taipei Report]
According to health insurance drug data statistics, there are hundreds of medications that should not be split or crushed. Drugs unsuitable for grinding or chewing include enteric-coated formulations, sustained-release formulations, sublingual formulations, or those with other specific reasons. The Pharmacists Association stated that certain oral special-formulation medications, if split or crushed due to factors like pediatric or tube-fed patients, may lose their extended-release effects or cause the entire dose to be released at once. This could lead to increased side effects, heightened toxicity, adverse reactions, and other risks, posing a significant concern for medication safety.
Statistics from the Pharmacy Department of Taipei City Hospital Zhongxiao Branch show that, in 2011, out of 911 pharmacist prescription consultations, 116 cases (12.5%) involved inappropriate drug formulations. Among these, physicians accepted pharmacists' recommendations and modified prescriptions in 112 cases (96.6% acceptance rate), including:
- 38 cases (33.9%) of drugs unsuitable for splitting,
- 38 cases (33.9%) of incorrect formulations prescribed by physicians,
- 31 cases (27.7%) of medications unsuitable for crushing in tube feeding,
- 3 cases (2.7%) of pediatric medications unsuitable for grinding,
- and 2 cases (1.8%) based on pharmacoeconomic considerations.
In 4 cases, physicians maintained the original prescription, including 1 case of a drug unsuitable for splitting and 3 cases of medications unsuitable for crushing in tube feeding.
Further analysis revealed that, in 2011, out of 816 cases handled by the hospital's discharge preparation service team, pharmacists intervened in 399 tube-fed patient cases (48.9%). Among these, 34 cases (8.5%) involved consultations with physicians due to medications unsuitable for crushing in tube feeding. Physicians accepted pharmacists' recommendations and modified prescriptions in 31 cases (91.2% acceptance rate), highlighting the high proportion of inappropriate drug crushing that warrants attention.
Medications unsuitable for grinding or chewing include:
1. **Enteric-coated formulations**: Designed to release the drug in the intestines or a specific site after passing through the stomach to avoid destruction by stomach acid or gastric irritation.
2. **Sustained-release formulations**: Extend the drug's duration of action, maintain stable blood concentrations, reduce dosing frequency, and improve patient convenience. Crushing these may cause rapid drug release, leading to sudden spikes in blood concentration, adverse reactions, toxicity, or loss of sustained-release effects, necessitating more frequent dosing.
3. **Sublingual formulations**: Intended for rapid absorption under the tongue to bypass liver metabolism. Grinding or swallowing these drugs reduces their effectiveness.
4. **Other reasons**: Includes drugs with strong irritant properties, those prone to staining teeth or mucous membranes, liquid medications, or drugs that easily degrade due to moisture.
Source: http://mag. udn. com/ mag/ life/ storypage. jsp? f_ART_ID=418629#ixzz29Qlh2vsb
Powdered Drugs Alter Efficacy, High Ratio Demands Attention
According to health insurance drug data statistics, there are hundreds of medications that should not be split or crushed. Drugs unsuitable for grinding or chewing include enteric-coated formulations, sustained-release formulations, sublingual formulations, or those with other specific reasons. The Pharmacists Association stated that certain oral special-formulation medications, if split or crushed due to factors like pediatric or tube-fed patients, may lose their extended-release effects or cause the entire dose to be released at once. This could lead to increased side effects, heightened toxicity, adverse reactions, and other risks, posing a significant concern for medication safety.
Statistics from the Pharmacy Department of Taipei City Hospital Zhongxiao Branch show that, in 2011, out of 911 pharmacist prescription consultations, 116 cases (12.5%) involved inappropriate drug formulations. Among these, physicians accepted pharmacists' recommendations and modified prescriptions in 112 cases (96.6% acceptance rate), including:
- 38 cases (33.9%) of drugs unsuitable for splitting,
- 38 cases (33.9%) of incorrect formulations prescribed by physicians,
- 31 cases (27.7%) of medications unsuitable for crushing in tube feeding,
- 3 cases (2.7%) of pediatric medications unsuitable for grinding,
- and 2 cases (1.8%) based on pharmacoeconomic considerations.
In 4 cases, physicians maintained the original prescription, including 1 case of a drug unsuitable for splitting and 3 cases of medications unsuitable for crushing in tube feeding.
Further analysis revealed that, in 2011, out of 816 cases handled by the hospital's discharge preparation service team, pharmacists intervened in 399 tube-fed patient cases (48.9%). Among these, 34 cases (8.5%) involved consultations with physicians due to medications unsuitable for crushing in tube feeding. Physicians accepted pharmacists' recommendations and modified prescriptions in 31 cases (91.2% acceptance rate), highlighting the high proportion of inappropriate drug crushing that warrants attention.
Medications unsuitable for grinding or chewing include:
1. **Enteric-coated formulations**: Designed to release the drug in the intestines or a specific site after passing through the stomach to avoid destruction by stomach acid or gastric irritation.
2. **Sustained-release formulations**: Extend the drug's duration of action, maintain stable blood concentrations, reduce dosing frequency, and improve patient convenience. Crushing these may cause rapid drug release, leading to sudden spikes in blood concentration, adverse reactions, toxicity, or loss of sustained-release effects, necessitating more frequent dosing.
3. **Sublingual formulations**: Intended for rapid absorption under the tongue to bypass liver metabolism. Grinding or swallowing these drugs reduces their effectiveness.
4. **Other reasons**: Includes drugs with strong irritant properties, those prone to staining teeth or mucous membranes, liquid medications, or drugs that easily degrade due to moisture.
Source: http://mag. udn. com/ mag/ life/ storypage. jsp? f_ART_ID=418629#ixzz29Qlh2vsb