Do I give the med or hold?

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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.

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Specializes in Dementia/ Geriatrics.

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.

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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.

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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.
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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.

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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.

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Ill try that tonight till I can speak with someone to clarify it

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.
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Specializes in Neuro ICU and Med Surg.

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.

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Specializes in Acute Care, Rehab, Palliative.

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.

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Specializes in CV Surgical, ICU.

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.

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Specializes in retired LTC.

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.

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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.

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