probably a very basic med question.....

[onthemark]

I have patients who take gel capsules (both colace and b12) but because the patients can't swallow these, I'm asked to open them and squirt in with their crushed meds. (Why they don't get these in pure liquid form, I don't know.) Does anyone know the best way of opening these gel capsules? One nurse said she pricks it with a needle, and others have told me they cut the capsules open with scissors. I feel there must be an appropriate way of getting the gel out and I wonder what anyone here might suggest. Thank you to whoever takes the time to answer this :)

[edmia, BSN, RN]

I think what all of the posters here need to realize is that none of these "ways around" the problem are really appropriate. the dosage can not be accurate. Look at the bigger picture, not just the "task". the doc needs to be told to order differently, the pharmacy needs to understand that what they are providing isn't appropriate. Solve the problem instead of working around it. Would you be happy to receive an unknown, inaccurate dose of a med?[/quote']

I agree morte. This happens a lot to us because patients become npo and need ng tubes but the docs don't adjust the po meds to be tube appropriate. I have colleagues who continue to document po meds as given and do things like cut open gel tabs.

I look for the doc, ask for a change in orders, and if they don't do this in a timely manner, I don't give the med. I page then to let them know that if they don't change the order, I'll be forced to report their orders as med errors since the administration route is not correct. I get the right formulation and route on my orders without a problem.

It's not safe to have the wrong formulation ordered. Someone is going to draw up that colace into a syringe and give it IV one day...

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[KelRN215, BSN, RN]

How about Vitamin D? I've only ever seen it in a gel-cap!

Some of my patients too are ordered the gel-cap of Colace even though it exists in a crushable tablet form. Apparently this is the doing of the pharmacy for some reason. Is there a pharmacologic difference between the two - gel-cap vs. tablet? I assume there wouldn't be but one can never be too sure!

Vitamin D also comes in liquid formulation. I've given liquid ergocalciferol and cholecalciferol before.

[narsshine]

dissolve it in hot water using medicine cup.. but make sure add cold water before giving it to the patient. :)

[FloatRN19]

In school I was taught to use a needle to prick the package and the gel cap and extract it that way. I haven't ever done it that way after actually getting my liscense. We always have docs around at night so getting it changed isn't too big of an issue.

[Donnagg123]

see if you can change to a crushable form of something similar. My pharmacy usually recommends senna.

[annie.rn]

dissolve it in hot water using medicine cup.. but make sure add cold water before giving it to the patient. :)

That's what I was thinking, too :-)

[thevez]

Colace has liquid for, B12 has sublingual form