Tube problems

Question 1

phenytoin

Answer 1

binds to the tube

Question 2

carbemazepine

Answer 2

binds to the tube

Question 3

diazepam

Answer 3

binds to the tube

Question 4

solution for using drugs that bind to the tube

Answer 4

administer with higher volume of water (30-60mls)

Question 5

hydrophobic drugs

Answer 5

bind to the tube

Question 6

hydrophilic drugs

Answer 6

do not bind to the tube

Question 7

drugs in acidic solutions

Answer 7

direct interaction with the drug and feed causing tube blockage

Question 8

chlorphenamine

Answer 8

direct interaction with the drug and feed causing tube blockage

Question 9

promethazine

Answer 9

direct interaction with the drug and feed causing tube blockage

Question 10

solution for drugs that cause a direct interaction between the drug and feed causing tube blockage

Answer 10

use alternative routes if possible

avoid using syrups

dilute drug as much as possible

flush before and after administration

Question 11

why do some drugs bind to the tube

Answer 11

hydrophobic drugs bind to the hydrophobic tube material

hydrophobic drugs bind to the tube
hydrophilic drugs do not bind to the tube

Question 12

why do some drugs directly interact with the feed to cause a blockage?

Answer 12

drugs denature the proteins or fats in the feed
cause them to precipitate out
causes a blockage in the tube

Question 13

fluroquinolones

Answer 13

direct interaction with drug and feed causing reduced drug absorption

Question 14

ciprofloxacin

Answer 14

direct interaction with drug and feed causing reduced drug absorption (greatest loss in comparison to other fluoroquinolone)

Question 15

ofloxacin

Answer 15

direct interaction with drug and feed causing reduced drug absorption (less loss than ciprofloxacin but not as little as moxifloxacin)

Question 16

moxifloxacin

Answer 16

direct interaction with drug and feed causing reduced drug absorption (least loss out of all the fluoroquinolone)

Question 17

why do some drugs and feed have an interaction that causes reduced drug absorption?

Answer 17

drug and feed itnteraction
drugs bind and complex with metal ions in the feed which causes reduced drug absorption

fluroquinolones bind with alkali metals and multivalent ions (for example Calcium ions (Ca) and Magnesium ions (Mg)

because they are bound and complexed with the metal ions the drug molecules aren’t free and therefore cannot be absorbed!!!

Question 18

what should you do if using a drug that is known to bind with the feed and cause reduced absorption?

Answer 18

be aware of the feed routine

stop feed 2 hours before and re-start 2 hours after drug administration

flushing required

Question 19

penicillin

Answer 19

drug requires administration on an empty stomach

Question 20

ketoconazole

Answer 20

drug requires administration on an empty stomach

Question 21

tetracyclines

Answer 21

drug required administration on an empty stomach

Question 22

what should you do if you are using a drug that you know needs administered on an empty stomach

Answer 22

be aware of the feed routine

stop feed 2 hours before and re-start feed 2 hours after drug adminsitratiom

Question 23

what kind of feeding would be inappropriate if you are using medicines that require administration on an empty stomach>

Answer 23

continuous

NJ route (as stomach is bypassed)

Question 24

what kind of feeding would be appropriate if you are using medicines that required administration on an empty stomach?

Answer 24

bolus or intermittent

Question 25

what BNF warning applies to drugs that require administration on an empty stomach

Answer 25

23

under medicinal forms –> cautionary and advisory labels

Question 26

what problem can sorbital cause

Answer 26

large quantity of sorbitol (excipient) may cause osmotic diarrhoea

remember multiple medicines may have the same excipients- additive effect

Question 27

what problem can liquids with high osmolarity cause and how can this be avoided

Answer 27

high osmolarity may cause osmotic diarrhoea

dilute liquid to reduce osmolarity

remember multiple medicines may have the same excipients- additive effect

Question 28

hydrochoride salts

Answer 28

direct interaction of drug and feed causing blockages

Question 29

malleates

Answer 29

direct interaction of drug and feed causing blockages

Question 30

tartrates

Answer 30

direct interaction of drug and feed causing blockages

Question 31

warfarin

Answer 31

direct interaction between feed and drug causing reduced drug absorption

Question 32

phenytoin

Answer 32

direct interaction between feed and drug causing reduced drug absorption