Do I give the med or hold?

  1. 1 I work in LTC, my resident is given gabapentin (time release capsule) along with a lot of other tablets. This resident chews all meds and will not listen that gabapentin states "swallow whole, do not chew, or crush". I see all the other nurses give this med and not worry about this.
  2. Visit  spectrabrite profile page

    About spectrabrite

    spectrabrite has '1' year(s) of experience. From 'Agoura Hills, CA, US'; 35 Years Old; Joined Nov '11; Posts: 154; Likes: 41.

    79 Comments so far...

  3. Visit  jacquelyn. profile page
    2
    If it is in the capsule can't you open it in applesauce. I would consult the doctor or pharmacist to get another form of the drug the patient can manage.
    turnforthenurseRN and elprup like this.
  4. Visit  BrandonLPN profile page
    4
    Maybe get the order changed to a non timed release version? In the meantime I wouldn't hold it. He still needs the med for his neuropathy pain (or whatever). It obviously is doing him no harm if he's been taking it that way forever. It's just not optimal.
  5. Visit  BrandonLPN profile page
    1
    Quote from jacquelyn.
    If it is in the capsule can't you open it in applesauce. I would consult the doctor or pharmacist to get another form of the drug the patient can manage.
    If he opened the capsule, then the time release mechanism wouldn't work.
    amoLucia likes this.
  6. Visit  spectrabrite profile page
    1
    everything I am reading is the chewing crushes the time release beads and causes the med to be released all at once flooding the body to quickly. I will take it up with my charge when she is back in the facility.
    CaitlinLiz likes this.
  7. Visit  bubblejet50 profile page
    1
    I would clarify with the doctor. They can change the form or it may be okay. I once had to put pradaxa down a g-tube and the bottle said do not open, swallow whole but the doctor said it was fine to send it down the tube. Try giving in pudding or applesauce until then if possible.
    spectrabrite likes this.
  8. Visit  spectrabrite profile page
    1
    Ill try that tonight till I can speak with someone to clarify it

    Quote from bubblejet50
    I would clarify with the doctor. They can change the form or it may be okay. I once had to put pradaxa down a g-tube and the bottle said do not open, swallow whole but the doctor said it was fine to send it down the tube. Try giving in pudding or applesauce until then if possible.
    Esme12 likes this.
  9. Visit  nrsang97 profile page
    4
    I agree to try to put the whole pill in pudding or applesauce. Some people are just terrible at swallowing pills. I wouldn't hold neurontin. We give neurontin and open the capsule to put it down the peg all the time. Our MAR has no warning about not doing so.
  10. Visit  loriangel14 profile page
    4
    It's not the best thing to do but I have opened Gabapentin ans put it in applesauce or pudding. It's either that or they don't get it at all.
    ktliz, SE_BSN_RN, spectrabrite, and 1 other like this.
  11. Visit  One Flew Over profile page
    1
    I believe it also comes in a liquid suspension form- obviously not time released so he would just have to get it more often. I agree though, don't hold.
    spectrabrite likes this.
  12. Visit  amoLucia profile page
    2
    Let me just ask - if you were on a med pass and were being observed by a State suveyor or pharmacy auditor, would you be opening the capsule and giving it??? There are side effects from improperly administering a XR med so would you risk those side effects for yourself or your family??? Is a pt any different?

    At one LTC facility, we had to give a vasodilator 6 am. This one resident usually swallowed it well for me; once in a rare while she would bite it and chew, but she was always in bed lying down. On one morning, she was fussing so we had her sitting up at the desk area; I gave her her med and she bit & chewed that time. It was a good thing she was at the desk; about 15 minutes later she was observed limp, barely responsive, diaphoretic and severely hypotensive. I believed it to be that pill whose directions said to take whole. Got that order changed REAL FAST to a nitro patch for the next day. The pill is scored, so I freq broke it and gave in applesauce but....she bit & chewed that day.

    There's reasons for warnings. I won't jeopardize pt safety, So back to the OP's med problem --- I'd hold the med and get the liquid ordered. If the MD balks, let nsg admin and pharmacy know so they can intervene. And I'd document well.
    SL2014 and spectrabrite like this.
  13. Visit  BrandonLPN profile page
    2
    Sometimes a physician might okay a timed release pill to be crushed or capsule opened. Sometimes the physician WANTS the pt to get the full effect all at once. It's not necessarily harmful. The longer you work in nursing, you will see med orders that go against the manufacturer's recomendations from time to time. I've inserted pills (actual pills, not suppository) rectally per phys order. You won't find *that* in any med handbook! Doesn't mean it's wrong or dangerous.
    ohioSICUrn and KelRN215 like this.
  14. Visit  amoLucia profile page
    0
    Brandon - without an explicit MD order or documented note, I'd still hesitate to admin a med NOT as recommended. I mean a maybe/ MIGHT, but I'd have to be real sure about it to proceed. I HAVE done so in the past.

    By the way, what were those meds you admin rectally???

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