Directions for administration of tablets

IMPORTANT! - Never leave medication drawn up into a syringe unattended. Never give the syringe to someone else to administer to the patient. Accidental intravenous administration of oral / enteral medication drawn up in syringes has led to fatalities.

Dispersible / disintegrating / soluble tablets - enteral tubes

Some tablets may disperse or disintegrate in water without crushing. If this is the case the tablet should be prepared as follows:

1. Place intact tablet into the barrel of a 50mL enteral syringe.
2. Replace the plunger and draw up 10-15mL of water.
3. Cap the syringe and allow the tablet to dissolve.
4. Shake well and administer dose down the enteral feeding tube.
5. Flush the tube post dose with 10mL of water.

Effervescent tablets - enteral tubes

These tablets will effervesce and disperse when placed in water. The resulting gases need to be allowed to escape. Prepare as follows:

1. Pour 50mL water into a beaker (some tablets require greater volumes of water - see individual monographs for advice).
2. Add the tablet to the water.
3. Wait for the effervescent reaction to finish.
4. Swirl the solution and draw it all up into a 50mL enteral syringe (in two aliquots if necessary).
5. Administer the dose down the enteral feeding tube.
6. Rinse the beaker with water and administer this also.
7. Flush the tube post dose with 10mL of water.

Dispersible / effervescent tablets - swallowing difficulties

Put the tablet in a beaker of water (sometimes a large volume is required - see individual monographs for details), and wait for the dispersal / effervescent reaction to finish. The patient should drink the solution immediately, and the beaker should then be rinsed with water and this should be drunk also to ensure the whole dose is given.

Tablets suitable for crushing - enteral tubes

Prepare the tablet as follows:

1. Crush the tablet with a pestle and mortar, a tablet crusher, or between two metal spoons.
2. Add the powder to 15-30mL of water and mix well.^214,225
3. Draw up the solution into a 50mL enteral syringe.
4. Administer the dose down the enteral feeding tube.
5. Rinse out the mortar / tablet crusher with water and administer this also.
6. Flush the tube post dose with 10mL of water.

Tablets suitable for crushing - swallowing difficulties

Prepare the tablet as follows:

1. Crush the tablet with a pestle and mortar, a tablet crusher, or between two metal spoons.
2. Add the powder to 15-30mL of water and mix well.²¹⁴
3. Draw up the solution into an oral syringe.
4. Administer the dose to the patient.
5. Rinse out the mortar / tablet crusher with water and administer this also.

DON'T
. crush tablets in plastic containers as the drug may adhere to the plastic.
. use boiling water to dissolve tablets as it may affect bioavailability.
. leave oral medicines unattended in syringes.
. administer any medicine that you have not prepared yourself.