What meds to crush and what not to crush?

  1. 0
    Besides your time release and enterics what absolutely cannot be crushed? Does anyone know of a list? If not, please write down some no no crushers...Also some of the enterics I can't tell if they are enteric or not? tips on being able to tell that except for the obvious ones that say enteric (EC)?
    The current setting I am in I find a huge number of patients require them crushed.
    Thanks a bunch!
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  3. 10 Comments so far...

  4. 0
    Oh, heck, I don't really remember. Depakote and dilantin are big non-nos, and I found I could get docs to substitute chrushable version. Anything with XL or XR sholdn't be. And definitely Avodart.

    The reality, though, is that if the patient can't swallow the doc MUST be made aware that his meds as ordered are unsuitable. It helps to note at the same time that a crshable one is available.
  5. 0
    Nurse tip of the day: after crushing meds to give through an enteric feeding tube add hot water (sinkorator). This allows meds to quickly dissolve. Then procede to add a little cool water to prevent scalding of patient's gastric lining.
  6. 2
    1 good tip: if it is something that is only taken once daily, and has SR, ER, XL, EC, or LA (slow release, extended release, long acting, enteric coated, etc.) in the name, you most likely don't want to crush it.

    Enterics have a coating that is pretty easily identified.

    Here is a list of non-crushable meds: http://www.ismp.org/Tools/DoNotCrush.pdf

    It's pretty extensive.
    CaLLaCoDe and SC-RN like this.
  7. 0
    Protonix
    Flomax
    Aggrenox
  8. 0
    One of the hospitals we did clinicals at told not to crush K-Dur if the pt asks but we can dissolve it in water if the pt is unable to swallow it whole.
  9. 1
    Quote from APBT mom
    One of the hospitals we did clinicals at told not to crush K-Dur if the pt asks but we can dissolve it in water if the pt is unable to swallow it whole.
    Potassium elixir might be a better idea.
    CaLLaCoDe likes this.
  10. 0
    Printable "Do Not Crush" list PDF.

    http://www.ismp.org/Tools/DoNotCrush.pdf
  11. 1
    Quote from Valerie Salva
    Printable "Do Not Crush" list PDF.

    http://www.ismp.org/Tools/DoNotCrush.pdf
    See post #4. :chuckle
    Valerie Salva likes this.
  12. 1
    I always try to get the med in liquid form if possible for g-tubes instead of crushing.. that way you are not battling the bits that stick to the inside of the cup and/or clumping that can occur; both of which affect the amount of medication the pt receives. Sometimes it has to be specially formulated but it is soooo worth it!! Another caution with liquid meds would be to ensure that the med is well shaken before administration. Had issues with liquid dilantin years ago.
    BBFRN likes this.


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