what meds do you routinely crush?

aknurs · Sep 17, 2008

At our facility we crush:

Tramadol

Soma

Klonopin

Anexia,& all Narcotics: as they are all popular drugs on the yard..we still do mouth checks,even if they are crushed, & sometimes, pocket checks.

In the Maximum house we crush the same drugs, plus if they are inmates who try to share their medications Or trade them, they also get crushed. Most of the time if they are caught, their medications get discontinued.

afteralltheseyears · Sep 17, 2008

Thanks. Inmates are complaining about nortriptyline burning their throat and making their mouth sore. I'm thinking nearly any crushed med will do that if you just take the powder into the mouth and then wash it down with water so I've been telling them to dump the water in powder and then drink the water. Anyone have experience with this?

Steristripqueen · Sep 17, 2008

I am sure the meds do burn but where I am it's more that they don't have control..can't see the meds/amt.. Not too long ago most were putting peanut butter in the roofs of their mouths to hide the meds. On one guy the meds fell onto his tongue so now penlights are used for mouth checks. I had one guy who could regurgatate his meds with no problem at all. If they don't want them or to sell their meds they will in the long run. We can only do the best we can on the med runs. I forgot to add that Ultram, Neurontin esp. are crushed. All of the nurses have completed injury reports because to be honest we are breathing in the 'dust' and handling these meds that were not to be crushed in the real world. We are worried with getting asthma/COPD down the road and figure we need help carrying our little O2 bottle around.

aknurs · Sep 20, 2008

Thanks. Inmates are complaining about nortriptyline burning their throat and making their mouth sore. I'm thinking nearly any crushed med will do that if you just take the powder into the mouth and then wash it down with water so I've been telling them to dump the water in powder and then drink the water. Anyone have experience with this?

That works, but there is sometimes powder residue, left in the cup, (if you put the powdered med in a cup of water). In that case they have to add more water to the cup, to get all of the med..It depends on how much time they have , to take the med.LOL I have approximately 110 inmates in my night medline, the officers, who do the mouth checks, usually want them to do the swallow,they look, & hit the road, routine.:chuckle

We use a pill crushing system, where the pill is placed in a plastic pouch,crushed via the crusher, then put in a souffle cup..There is minimal dust, but yes there is a concern,about breathing the dust....It's too bad any of then, have to be crushed

deyo321 · Sep 20, 2008

We crush all meds that can be crushed. All. Motrin, vitamins, all. We then put in applesauce. Apparently celexa is the worst tasting drug around, judging by their faces. We do not do narcotics here; ok rarely. We do serax for detox and phenobarb for seizure. People get so disappointed that they cant have their percocets in jail. I have detoxed so many people off methadone who are convinced they will die without it. I swear the clinics brainwash them. I have had IM's say "if I knew it would be that easy I would have stopped years ago" Course the easy part is that they cant get it here. The sad part is that they cant maintain it when released, so next time back (because they all come back) here we go again. Seroquel is a popular drug to share so I pulvarize it. For pain control we use tramadol, soma, motrin, relafen or some combo of.

We recently had some small pieces of what looked like seroquel found in a cell. We batted around the idea of floating but it is time consuming and I feel like if you are gonna try to hang on to meds with your back teeth the are harder to isolate in applesauce. Also we can think of every possible control and still we will not eradicate IMs bad behavior with meds.

My med cart right now has one (1) narc card for count. That rocks!!

MadisonsMomRN, BSN, RN · Sep 20, 2008

Meds that can be crushed are crushed at our facility BUT only if its medically indicated. Also, we do NOT give any narcs out to anyone unless they are in the infirmary (at the prison I work in) or medical (at the detention center I work in) The detention ctr only gives Tylenol 3 (while in medical only) We give Serax, Librium and clonodine for withdrawal (again they cannot be on the block with it). Phenobarb for seizures. The prison does have narcs like oxycodone, percocet, etc but they can only be given to them while they are in the infirmary.

At the detention ctr I work in... we sometimes "crush and float" seroquel. It really ticks the inmates off.

kito4149 · Sep 21, 2008

The only med we crush here is Elavil. If we know that an i/m is selling or hoarding his meds, we automactically d/c and notify the physician. Also if we feel that an i/m is taking too many meds (ibuprofen, naproxen, Robaxin, and tramadol at the same time 2-3 times a day) and there is no apparent reason, we take them off and talk with the physician.

2003rn, ASN, RN · Sep 21, 2008

We crush all narcotics.

houstonlvn · Oct 13, 2008

I do understand the need to crush certain meds, but TRAMADOL?

That one I don't get.

Is it just because some other inmates want it?

aknurs · Oct 15, 2008

I do understand the need to crush certain meds, but TRAMADOL?
That one I don't get.
Is it just because some other inmates want it?

It's a really popular drug "on the yard" where I work...Popular meds get crushed, unless there is a contraindication. But I have seen inmates that have gotten caught with cheeking liquid meds, after a mouth search...It's Totally amazing (& educational) as to how they do it.

geode19947 · Nov 3, 2008

Wondering what meds you routinely crush at your sites?

We don't actually crush our meds, we do what is called "floating". We placed the pills in a small plastic pill cup and add water...the pill dissolves in the water and is tolerated well when swallowed. We float Vicodin for the most part. Hope that's helpful. :idea: