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Pharmacy Revision > To Crush or Not to crush > Flashcards

To Crush or Not to crush Flashcards

For patients who can't swallow, can their medication be altered..

1
Q

Acetazolamide MR

A

DO NOT CRUSH

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2
Q

Acetazolamide

A

Non MR?

Yeah go ahead and disperse this in water

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3
Q

Alendronate

A

LAST RESORT - crush and administer via NG/PEG tube if ESSENTIAL patient continues treatment

REMEMBER must be given on an EMPTY STOMACH - which means after 4 hour fast, and 30 minutes before any other medication or food

does the patient really need to be on this?
Maybe consider changing to strontium if for post menopausal osteoporosis

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4
Q

Alfuzosin MR

A

DO NOT CRUSH

change to non-MR

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5
Q

Alfuzosin

A

Non MR?

Yeah go ahead and disperse this in water

if changed from MR then 2.5mg TDS which can be crushed and dispersed in water

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6
Q

Allopurinol

A

Yeah go ahead, crush, mix with water and administer

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7
Q

Alverine

A

Yeah go ahead - Capsule can be opened and dispersed in water

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8
Q

Aminophylline

A

NO
Change to equivalent dose of theophylline liquid - 60mg/5ml
Stop feed for 1 hour before an 2 hours after and monitor plasma levels of the drug

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9
Q

Amiodarone

A

Yeah go ahead and disperse this in water

Will not taste nice so can be mixed with fruit juice if NOT for enteral feeding tube

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10
Q

Amlodipine

A

Yeah go ahead and disperse this in water

NB to administer immediately as light sensitive

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11
Q

Anastrazole

A

Yeah go ahead, crush, mix with water and administer

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12
Q

Atorvastatin

A

Yeah go ahead, crush, mix with water and administer
(not very soluble, therefore if given via enteral feeding tube make sure tube is flushed well after administration to avoid blockage)

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13
Q

Azathioprine

A

Yeah go ahead, crush, mix with water and administer

CYTOTOXIC - so remember to wear gloves, and dispose of container and clean up spillages as per cytotoxic guidelines

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14
Q

Bendroflumethiazide

A

Yeah go ahead and disperse this in water

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15
Q

Betahistine

A

Yeah go ahead and disperse this in water

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16
Q

Bezafibrate

A

Non-MR?

Yeah go ahead, crush, mix with water and administer

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17
Q

Bezafibrate MR

A

DO NOT CRUSH

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18
Q

Bisoprolol

A

Yeah go ahead, crush, mix with water and administer
(not very soluble, therefore if given via enteral feeding tube make sure tube is flushed well after administration to avoid blockage)

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19
Q

Buspirone

A

Yeah go ahead, crush, mix with water and administer

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20
Q

Cabergoline

A

Yeah go ahead, crush, mix with water and administer

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21
Q

Calcium/Vitamin D3

A

If unable to chew CHANGE to Calfovit D3 sachets at equivalent dose

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22
Q

Candesartan

A

Yeah go ahead, crush, mix with water and administer

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23
Q

Captopril

A

Yeah go ahead disperse in water

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24
Q

Carbimazole

A

Yeah go ahead, crush, mix with water and administer

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25
Q

Carvedilol

A

Yeah go ahead, crush, mix with water and administer (will form a suspension)

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26
Q

Celecoxib

A

DO NOT OPEN CAPSULES - will affect the stability of the drug

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27
Q

Chlordiazepoxide

A

Yeah go ahead open the capsule, mix with water and administer

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28
Q

Cinnarizine

A

Yeah go ahead, mix with water and administer

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29
Q

Ciprofloxacin

A

Yeah go ahead, crush, mix with water and administer

suspension is too think for enteral feeding tubes

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30
Q

Citalopram

A 
DROPS AVAILABLE
NB 8mg (4 drops) = 10 mg tablets

Mix with water before administering

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31
Q

Clindamycin

A

Yeah go ahead, open capsule, mix with water and administer

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32
Q

Clobazam

A

Yeah go ahead, crush, mix with water and administer

does not taste nice

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33
Q

Clonazepam

A

Yeah go ahead, crush, mix with at least 30 mls of water and administer

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34
Q

Clopidogrl

A

Yeah go ahead disperse in water and administer (will take about 5 minutes to completely disperse)

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35
Q

Co-amilozide

A

Yeah go ahead, crush, mix with water and administer

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36
Q

Co-beneldopa

A

DISPERSIBLE TABLETS AVIALABLE

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37
Q

Co-careldopa

A

Yeah go ahead, crush, mix with water and administer

consider changing to co-beneldopa dispersible tablets

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38
Q

Co-phenotrope

A

Yeah go ahead, crush, mix with water and administer

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39
Q

Cyclizine

A

Yeah go ahead, crush, mix with water and administer

Bitter taste

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40
Q

Cyproterone

A

Yeah go ahead, crush, mix with water and administer

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41
Q

Dantrolene Capsules

A

Yeah go ahead, open the capsule, mix with ORANGE JUICE and administer - maintain the acidity

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42
Q

Demeclocyline

A

DO NOT OPEN CAPSULES

contents of the capsule do not disperse in water and may cause severe irritation to the mucosa

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43
Q

Digoxin

A

LIQUID FORMULATION AVAILABLE

NB bioavailablity different
62.5mcg tablet = 50 mcg liquid

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44
Q

Diltiazrm

A

OD MR and BD MR preparations should NOT BE CRUSHED

The 60mg MR TDS formulation is not slow released and CAN BE CRUSHED

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45
Q

Dipyridamole

A

SYRUP AVAILABLE

But yeah go ahead, open the capsule, mix with water and administer buy mouth NOT SUITABLE FOR ENTERAL FEED

DO NOT CRUSH TABLETS

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46
Q

Donepezil

A

Yeah go ahead, crush, mix with water and administer

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47
Q

Doxazosin

A

Yeah go ahead, mix with (STERILE- not tap) water and administer

48
Q

Entacapone

A

Yeah go ahead, crush, mix with water and administer
(not very soluble, therefore if given via enteral feeding tube make sure tube is flushed well after administration to avoid blockage - may stain orange)

49
Q

Eprosartan

A

Yeah go ahead, crush, mix with water and administer

50
Q

Escitalopram

A

Consider switching to citalopram which is available as a liquid

51
Q

Esomeprazole

A

Yeah you can..but it will leave pellets which SHOULD NOT be crushed.

consider a different PPI?

52
Q

Ethambutol

A

Yeah go ahead, crush, mix with water and administer

53
Q

Exetimibe

A

NOPE

does not mix well with water

54
Q

Felodipine

A

MR - DO NOT CRUSH

Consider changing to amlodipine - which can be crushed

55
Q

Ferrous Sulphate

A

LIQUID PREP AVAILABLE

Change to equivalent dose

56
Q

Finasteride

A

Place the tablet IN THE BARREL of an oral or bladder-tipped syringe, draw up water and allow to dissolve.

NB WOMEN OF CHILD BEARING AGE should NOT handle crushed, broken or dissolved tablets

57
Q

Fludrocortisone

A

Yeah go ahead, crush, mix with water and administer

58
Q

Forceval

A

snip off the end of the capsule and withdrawal contents using a syringe

Does not mix well with water - so be careful if using an enteral feeding tube

Unpleasant taste.

59
Q

Gabapentin

A

Yeah go ahead, open the capsule, mix with water and administer immediately

60
Q

Glibenclamide

A

Yeah go ahead, crush, mix with water and administer

61
Q

Gliclazide

A

Non-MR?

Yeah go ahead, crush, mix with ORANGE JUICE and administer

62
Q

Glimepiride

A

DO NOT CRUSH - my affect bioavailability

63
Q

Glipizide

A

Yeah go ahead, crush, mix with water and administer

64
Q

Hydrocortisone

A

Yeah go ahead, crush, mix with water and administer

65
Q

hydroxyurea

A

CYTOTOXIC - Handle with care but Yeah, capsules can be opened, mixed with water and administer

66
Q

Hyoscine Butylbromide

A

DO NOT CRUSH

Administer injection orally if necessary

67
Q

Hyoscine Hydrobromide

A

PATCH AVAILABLE

68
Q

Irbesartan

A

Yeah go ahead, crush, mix with water and administer

69
Q

Isosorbide Dinitrate

A

Non-MR?

Yeah go ahead, crush, mix with water and administer

70
Q

Labetalol

A

Injection can be used orally

mix with orange juice if necessary to disguise bitter taste

71
Q

Lansoprazole

A

SUSPENSION SACHETS AVAILABLE - not suitable for enteral feeding tube (liquid sticks to the tube)

FAST-TABS available which can either be swallowed whole, dissolved in the mouth, or dissolved in water if necessary

72
Q

Levomepromiazine

A

Yeah go ahead, mix with water and administer

or use the injection orally

73
Q

Levothyroxine

A

Yeah go ahead, crush, mix with water and administer

74
Q

Lisinopril

A

Yeah go ahead, mix with water and administer

75
Q

Lorazepam

A

Yeah go ahead, crush, mix with water and administer

76
Q

Lormetazepam

A

Yeah go ahead, mix with water and administer

or change to temazepam

77
Q

Losartan

A

Yeah go ahead, crush, mix with water and administer

78
Q

Menadiol

A

Yeah go ahead, crush, mix with water and administer

79
Q

Mesalazine

A

GRANULES AVAILABLE - these are MR and will contain small particles - may not be suitable to go down enteral feeding tube

80
Q

Metformin

A

Yeah go ahead, crush, mix with water and administer

Metformin SATCHETS are available in 500mg and 1 G

81
Q

Methylprednisolone

A

Yeah go ahead, mix with water and administer

82
Q

Metolazone

A

Yeah go ahead, crush, mix with water and administer

83
Q

Metoprolol

A

Yeah go ahead, crush, mix with water and administer

or use injection orally

84
Q

Mirtazepine

A

ORODISPERSIBLE TABLETS will dissolve in water

85
Q

Monteleukast

A

CHEWABLE TABLETS will disperse in water

86
Q

Moxonidine

A

Yeah go ahead, crush, mix with water and administer

87
Q

Morphine Sulphate MR Caps (zomorph)

A

Yeah go ahead, open capsule (BUT DO NOT CRUSH), mix with water and administer

or change to Oramorph

88
Q

Naftidrofuryl

A

Yeah go ahead, open capsule, mix with water and administer

NOTE: risk of oesophageal stricture if used orally in patients with swallowing difficulties - to avoid this the patients should drink 4-5 glasses of water after each dose

89
Q

Nicardipine

A

Non-Mr capsules?

Yeah go ahead, open capsules, mix with ORANGE JUICE and administer

90
Q

Nicorandil

A

Yeah go ahead, crush, mix with water and administer

NB: tablets are hygroscopic and they should be used with care in enteral feeding tube as may cause blockage

91
Q

Nifedipine

A

MR? - DO NOT CRUSH

as non-MR are not recommended for treatment of angina or long term control of hypertension, it is better to change to an alternative CCB such as amlodipine which can be dispersed in water

92
Q

Nimodipine

A

Yeah go ahead, crush, mix with water and administer immediately

93
Q

Olanzepine

A

Use VELOTABS and disperse in water

94
Q

Pantoprazole

A

DO NOT CRUSH

consider changing to alternative

95
Q

Phenelzine

A

Yeah go ahead, crush, mix with water and administer immediately (unstable in water)

96
Q

Phenytoin

A

SYRUP AVAILABLE
90mg Syrup = 100mg Capsule

for enteral feed - to avoid adsorption to the tubing, mix with equal volume of water and flush with 30ml of water before and after administering phenytoin

97
Q

Pramipexole

A

Yeah go ahead, crush, mix with water and administer

98
Q

Pravastatin

A

Yeah go ahead, crush, mix with water and administer

99
Q

Prazosin

A

Yeah go ahead, crush, mix with water and administer

100
Q

Quetiapine

A

Crush and dissolve in WARM water

For oral use can mix crushed tablet with yogurt to disguise bitter taste

101
Q

Ramipril

A

Yeah go ahead, crush, mix with water and administer

Capsules can be opened and dispersed in water

102
Q

Riluzole

A

Yeah go ahead, crush, mix with water and administer

Crushed tablets can also be mixed with soft food (such as yogurt) to aid swallowing

103
Q

Risedronate

A

LAST RESORT - crush and administer via NG/PEG tube if ESSENTIAL patient continues treatment

REMEMBER must be given on an EMPTY STOMACH - which means after 4 hour fast, and 30 minutes before any other medication or food

104
Q

Rosiglitazone

A

Yeah go ahead, crush, mix with water and administer

105
Q

Sertraline

A

Yeah go ahead, mix with water and administer

can be crushed and mixed with food

106
Q

Simvastatin

A

Yeah go ahead, crush, mix with water and administer

107
Q

Sotalol

A

Yeah go ahead, crush, mix with water and administer

108
Q

Tamsulosin

A

MR SHOULD NOT BE CRUSHED

change to an alternative alpha-blocker

109
Q

Theophylline

A

LIQUID AVAILABLE

Stop feed for 1 hour before an 2 hours after and monitor plasma levels of the drug

110
Q

Tolbutamide

A

Yeah go ahead, crush, mix with water and administer

111
Q

Tolterodine

A

Yeah go ahead, mix with water and administer

112
Q

Tranexamic Acid

A

Yeah go ahead, crush, mix with water and administer - Can take upto 5 minutes to dissolve

Injection can be used orally

113
Q

Valsartan

A

Capsules can be opened and dispersed in water

Use immediately!

114
Q

Vacomycin

A

Injection can be used orally

115
Q

Venlafaxine

A

Non-MR?

Yeah go ahead, crush, mix with water and administer

116
Q

Warfain

A

Yeah go ahead, crush, mix with water and administer

117
Q

Zopiclone

A

DO NOT CRUSH

consider changing to temazepam liquid

Pharmacy Revision (11 decks)

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