Medication Administration Through Enteral Feeding Tubes

Nancy Toedter Williams, Pharm.D., BCPS, BCNSP

Disclosures

Am J Health Syst Pharm. 2008;65(24):2347-2357. 

In This Article

Other Options for Medication Administration

For patients who are unable to take medications orally, the necessity of drug therapy, as well as alternative routes of drug delivery, should be considered before administering medications through an enteral feeding tube. In critically ill patients, hormone replacement therapy or lipid-lowering agents may be temporarily suspended until the patient can resume the oral route because these medications may generally be held for a short duration without notably harming the patient. However, for medications deemed necessary, an alternative route of administration may be considered. These alternatives include drug administration via transdermal, sublingual or buccal, rectal, or injectable routes. Unfortunately, there are limited medications available via transdermal delivery, and the sublingual and buccal routes may be inappropriate options because of mouth injuries, decreased mental status, dry mouth, excessive salivation, or vomiting. Rectal administration may be undesirable or uncomfortable in some patients, and parenteral routes, including intravenous, intramuscular, and subcutaneous injections, are usually more costly, inconvenient, and painful and require trained staff. The use of intravenous lines may also increase the potential for infections and other complications.[5,12,13] For products without various dosage formulations, another option involves switching to a medication that works similarly but can be administered via alternative routes. However, dosage changes may be needed for an equivalent effect.[5,13]

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