Mickey buttons and lansoprazole capsules

[Blackcat99]

I open the capsule and mix the ingredients in water or apple juice. The little white granules always block and clog up my patient's mickey button. What can I mix it with to put a stop to the clogging of the mickey button? Thanks for any advice.

[wooh, BSN, RN]

Agree mixing with sodium bicarb is going to be your best bet if you can't get solutabs or liquid. Make sure you're using the straight in type of extension rather than the L shape extension. When I've had to push pancreatic enzymes (the same kind of annoying bugaboo to administer and there's not a liquid choice), I've found my best bet is to get a big 60 cc syringe, go for about 30 cc of about 2/3 apple sauce, 1/3 apple juice. And PUSH. Gravity isn't going to work.

[imintrouble, BSN, RN]

Pudding or AS is what I always use and it works like a charm.

[GitanoRN, BSN, MSN, RN]

Undoubtedly, I recall using the applesauce & the pudding they both worked like a charm

[ClearBlueOctoberSky]

Ah, the things they don't tell you in school.

I know about coke flushes, I didn't know that you could utilize applesauce (diluted, correct?)

Thanks!

[wooh, BSN, RN]

Ah, the things they don't tell you in school.

I didn't know that you could utilize applesauce (diluted, correct?)

Thanks!

Doesn't even have to be diluted. Apple sauce is about the closest thing nurses have to a secret weapon. :)

[mustang 66]

My daughter has Gateway and they pay for the Prevacid solutab. Works great and dissolves instantly... A little leg work from the Doctor but is approved...the generic just doesn't work and we went through alot of buttons before the Doctor had other patients with the same problems and decided to push the solutabs thru...

[mustang 66]

Yes, they would. How much for the button VS. the Solutab??/Dah???What a waste of $.

[wooh, BSN, RN]

It's like the medicaid patient we had, getting an IV med once per day. Medicaid wouldn't pay for an infusion nurse to come to the house once a day until they'd paid for a couple months of having it done in the hospital. (She was my fave patient. Spent a couple hours in the morning and was done with her for the day except for a few PO meds here and there. And her mom taught me some spanish!)

[KelRN215, BSN, RN]

It's like the medicaid patient we had, getting an IV med once per day. Medicaid wouldn't pay for an infusion nurse to come to the house once a day until they'd paid for a couple months of having it done in the hospital. (She was my fave patient. Spent a couple hours in the morning and was done with her for the day except for a few PO meds here and there. And her mom taught me some spanish!)

We had a patient like that once who needed several weeks of IV antibiotics. Medicaid wouldn't pay for home care but they paid the full cost to keep this patient in the hospital for the duration of antibiotic therapy.

[wooh, BSN, RN]

Penny wise, pound foolish. That's medicaid (and well, all insurers) for ya! Much like the, "No, we won't pay for the antibiotic that you need to actually get rid of the bacteria in your wound. But we WILL pay for the antibiotic you tried before you were hospitalized for a week because it didn't work." These are the reasons I will NEVER be a case manager. I would constantly be crying tears of frustration.

[GamerNurse]

I do home care for a little girl whose mother is one of the higher up in the pharmaceutical dept of a major company. Her daughter has a Mic-Key button and she had been getting the solutabs, but now we're getting the capsules, which we hate, but the pharmacy is having a hard time getting the solutabs right now. Being that the mom works and makes these drugs, the nurses ran it by her to make sure she was ok with it. But while they tell you not to crush the little balls cause it destroys the med. It won't destroy it right away, so we dump the balls, crush it, put it in warm water and give it right away so it's in her stomach in less than a minute or two. She's been fine with it and she's one who use to throw up a lot. She's also on a fluid restriction so we have to watch which nurse is using how much water for their shift. Some nurses are greedy!!

[kids]

I was told that medicaid refuses to pay for the liquid formulation.

But they very often will pay for the capsules to be turned into a liquid by a compound pharmacist.

Agree mixing with sodium bicarb is going to be your best bet if you can't get solutabs or liquid.

Which is the method a compound pharmacist uses to make the capsules into a liquid: dissolve it in sodium bicarb then mix it with sterile water to a uniform concentration. The down side is that it has to be refrigerated (no preservatives).