A majority of tube-fed patients are on medications that require special precautions

摘要

SIR—Many patients in general hospitals receive food and medication through enteral feeding tubes [1]. Although common in clinical practice, this form of medication delivery is not always effective or safe and can lead to interactions, altered bioavailability, reduced absorption due to drug–nutrient interaction, altered pharmacokinetics, osmotic adverse effects due to sorbitol (a suspension vehicle) and tube blockage [2–5]. Interactions with enteral feeding formulae are the commonest cause of drug interactions in tube-fed patients and are more likely in tube-fed patients [6]. It is, therefore, imperative that when medications are being co-administered with food in tube-fed patients, special instructions are issued to administering personnel in an effort to maximise efficacy of medication and minimise the risk of adverse events, including selection of appropriate formulations, dose adjustment, special instructions such as dilution of the formulation to prevent caking, withholding feeding around medication timings, upright posture and post-dose flushing instructions. The extent to which this may be a problem in general hospitals has not yet been quantified.nnWe undertook a study in our institution to determine the prevalence of prescription of medications that required special precaution in tube-fed patients.