Questions on medicines, procedures and practice from hospice staff
1. Can we crush the patient’s cardiac medication to go via her PEG?
Each medication needs to be considered individually as there are specific issues with certain preparations which might not be predicted. Most immediate-release film-coated tablets may be crushed and dispersed in water but it is important to check with the pharmacist who visits or call the unit.
Please note that all members of staff who have access to Live View can also use the excellent resource – the NEWT guidelines. This guide is written by pharmacists and regularly updated to provide precise information on the safest and most effective way to administer a medicine when the sold dose form is not suitable.
2. Can tranexamic acid be given by SC injection?
Around 95% of injectable medicines are not licensed for subcutaneous (SC) use but we have a great body of clinical experience with using many off-licence. Recently, tranexamic acid has been a useful addition to this list.
In situations where the oral route is no longer possible and bleeding has been controlled well using the tablets, subcutaneous infusion of the injection is worth considering. The dose is the same as the oral one and it may not be possible to dilute the injection as the volumes required for the dose may be 15 to 20mls. A fact sheet is available, so please ask your visiting pharmacist.
Do you have a query about medicines or procedures in your hospice? Email us at email@example.com – it could appear in the next issue of our newsletter!