NEWT guidelines. Crushing tablets..

[jamuk87]

Hi guys,

I'm a community pharmacist and so don't really have much access to a lot of the clinical literature.

I've had an enquiry from the GP next door about crushing certain tablets and if this affects the bioavailability/efficacy etc. From my brief stint in working in hospital, I believe it's the NEWT guidance that can give me this information? Although I'm not sure.

The medicines in question are:

Nitrazepam
Paracetamol
Senna
Alendronic acid
Omeprazole
Donepezil

The patient in question is extremely fussy and won't take the liquid preparations but is okay with crushing tablets and dispersing them in water, although i'm not entirely sure why. Obviously I can suggest paracetamol soluble. With Losec MUPs capsules they can be opened and added to a bit of yoghurt or juice for example and I'm sure donepezil can be crushed and added to water but not sure about the others.

If anyone has access to the guidance can you please shed a bit of light for me, it would be muchly appreciated.

Cheers guys.

[Nik]

NEWT is one of the sources - the other is the handbook of drug administration via enteral feeding tubes, which gives info crushing and alternative preps:

Handbook of drug administration via ... - Google Books

I would be a bit more cautious about crushing alendronate. Could also consider lansoprazole fastabs instead of generic omeprazole caps.

[jamuk87]

Cheers Nik, you're a star.

How are you anyway? It's been a while since we spoke.

[crit care]

you could always consider strontium granules in place of alendronate?!

[Nik]

Yep better than crushing a bisphosphonate

Cheers Nik, you're a star.

How are you anyway? It's been a while since we spoke.

Doing well thanks, cramming as much as I can before the exam.

[jamuk87]

you could always consider strontium granules in place of alendronate?!

Yup, I made that suggestion to the GP.