[chadash]

I have a very basic question. Why, in particular, does K-dur have an enteric coating? Is it hard on the esophagus, the stomach? Does it taste real yucky? Is it to delay release of the med until it is in the intestine? That would probably determine how it should be handled in a tube feeding.

[Beary-nice]

Originally Posted by chadash

I have a very basic question. Why, in particular, does K-dur have an enteric coating? Is it hard on the esophagus, the stomach? Does it taste real yucky? Is it to delay release of the med until it is in the intestine? That would probably determine how it should be handled in a tube feeding.

The K-Dur I know is a large...and I mean large whitish colored pill that is scored down the middle and is made up of hundreds of little tiny beads. I would think the enteric coating makes it easier to swallow...well sometimes...it's such a darn big pill...you can break it in half...I have had pts tell me it doesn't taste good and it kinda burns when I have broke it for them. Nonetheless...it is a delayed release tablet...should never be crushed...should never be put down a feeding tube...you need to get an alternative. And yes, potassium chloride is hard on the esophagus and stomach...should be taken with plenty of water and with food.

[chadash]

So sounds like if it is crushed, it might cause gastric irritation with a feeding tube (potassium is an irritant) so if the feeding tube is in the stomach, ouch?

[RN and Mommy]

Here's what my Davis Drug Guide says about it...

PO: Administer with or after meals to decrease GI irritation.
Use of tablets and capsules should be reserved for patients who cannot tolerate liquid preparations.
Dissolve effervescent tablets in 3–8 oz of cold water. Ensure that effervescent tablet is fully dissolved. Powders and solutions should be diluted in 3–8 oz of cold water or juice (do not use tomato juice if patient is on sodium restriction). Instruct patient to drink slowly over 5–10 min.
Tablets and capsules should be taken with a meal and full glass of water. Do not chew or crush enteric-coated or extended-release tablets or capsules. Micro-K ExtenCaps capsules can be opened and sprinkled on soft food (pudding, applesauce) and swallowed immediately with a glass of cool water or juice.

[Beary-nice]

Originally Posted by chadash

So sounds like if it is crushed, it might cause gastric irritation with a feeding tube (potassium is an irritant) so if the feeding tube is in the stomach, ouch?

It can cause ulceration indeed, pts shouldn't even chew on the tablets...and there are some out there that will do that. The problem with the feeding tube is that for one if you crush it, you are also crushing all of those tiny sustained released beads in the tablet plus it is a risk in plugging the tube. Never...never do it...get a liquid or like another poster suggested the kind that dissolve in water. K-Dur is meant to release in a specific way once in your system, altering it by crushing it can create huge problems.

[Beary-nice]

Originally Posted by Sabrina's Mommy

Here's what my Davis Drug Guide says about it...

PO: Administer with or after meals to decrease GI irritation.
Use of tablets and capsules should be reserved for patients who cannot tolerate liquid preparations.
Dissolve effervescent tablets in 3–8 oz of cold water. Ensure that effervescent tablet is fully dissolved. Powders and solutions should be diluted in 3–8 oz of cold water or juice (do not use tomato juice if patient is on sodium restriction). Instruct patient to drink slowly over 5–10 min.
Tablets and capsules should be taken with a meal and full glass of water. Do not chew or crush enteric-coated or extended-release tablets or capsules. Micro-K ExtenCaps capsules can be opened and sprinkled on soft food (pudding, applesauce) and swallowed immediately with a glass of cool water or juice.

Good job Sabrina's Mommy...that is what my Davis's says too.

I have given hundreds of K-Dur tablets over the years. I shudder when I come on the job on the weekends to find a pt has a feeding tube in place, has potassium supplement ordered, has only K-Dur in their med drawer and when I ask where is the liquid stuff at....I get told...oh we have just been crushing those...ugh! You can bet I'm getting that changed PDQ!

[banditrn]

There are so many forms of K+ that can be administered by feed tube - if they are crushing the Kdur, that should be considered a med error.

[VickyRN]

Information from the manufacturer of K-Dur concerning crushing:

Information for Patients: Physicians should consider reminding the patient of the following:

To take each dose with meals and with a full glass of water or other liquid.

To take each dose without crushing, chewing, or sucking the tablets. If those patients are having difficulty swallowing whole tablets, they may try one of the following alternate methods of administration:
a. Break the tablet in half, and take each half separately with a glass of water.
b. Prepare an aqueous (water) suspension as follows:
1. Place the whole tablet(s) in approximately 1/2 glass of water (4 fluid ounces).
2. Allow approximately 2 minutes for the tablet(s) to disintegrate.
3. Stir for about half a minute after the tablet(s) has disintegrated.
4. Swirl the suspension and consume the entire contents of the glass immediately by drinking or by the use of a straw.
5. Add another 1 fluid ounce of water, swirl, and consume immediately.
6. Then, add an additional 1 fluid ounce of water, swirl, and consume immediately.

Aqueous suspension of K-DUR tablets that is not taken immediately should be discarded. The use of other liquids for suspending K-DUR tablets is not recommended.

http://www.spfiles.com/pikdur.pdf

[AuntieRN]

I do not mean to sound stupid or anything by asking this ( I am a student in my last semester..YAY!!) but....isn't K-DUR a form of potassium? We were always taught you were not supposed to ever crush potassium....is this correct? or is K-DUR different and you just do not crush regular straight pottasium...or is there even a difference? Thanks yall.....

[HappyNurse2005]

yes, k dur is potassium.