Enteral tube administration of oral chemotherapy drugs

Spencer, Samantha; Menard, Shannon; Labedz, Malgorzata Z; Krueger, Courtney; Sarna, Katherine V

doi:10.1177/1078155219893449

Cited by 19 publications

(19 citation statements)

References 43 publications

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“…Existing studies believe that, from the perspective of drug metabolism, this is mainly due to the toxicity of the central metabolite of CPT-11. The occurrence of diarrhea may be due to the direct damage of SN-38 to the intestinal tract [ 21 ]. Intestinal flora, such as Escherichia coli , Clostridium perfringens , and β -glucuronidase produced by Bacteroides, can convert SN-38G back to SN-38, thereby destroying the intestinal epithelium and reducing intestinal inflammation.…”

Section: Concepts Related To the Management Effect Of Cancer Patients...mentioning

confidence: 99%

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Chen

Zhang

Li³

2022

Journal of Healthcare Engineering

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With the pollution of the environment and the acceleration of the social rhythm, the prevalence of tumors has increased year by year, and tumors have brought huge pain and inconvenience to patients. However, traditional nursing work consumes a lot of manpower and material resources, but it is difficult to improve the happiness of cancer patients, and it also brings a lot of troubles to many nursing workers. Based on the above reasons, we reengineered the traditional nursing process based on the BPR theory and applied the new process to the analysis of the management effect of cancer patients after oral chemotherapy drugs. The data shows that there are 23 patients with no pressure ulcer risk (score greater than 19) before care, 27 patients with low risk (15–19 points), 32 patients with moderate risk (13–14 points), and 18 people at high risk (less than 12 points). After nursing, there were 82 patients with no pressure ulcer risk, 10 patients with low risk, 7 patients with moderate risk, and 1 patient with high risk. This shows that the risk of pressure ulcers in patients with cancer after the use of chemotherapy drugs is significantly reduced compared with those without nursing. Nursing intervention can improve the psychological state of cancer patients during the recovery period, and nursing intervention can promote the compliance of cancer patients in various aspects of rehabilitation.

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Section: Concepts Related To the Management Effect Of Cancer Patients...mentioning

confidence: 99%

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Chen

Zhang

Li³

2022

Journal of Healthcare Engineering

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“…The insufficient availability of liquid dosage forms is often the reason for the high consumption of solids. 1,4,7 Therefore, the crushing or dispersing immediate-release solid oral dosage forms (eg, coated/uncoated tablets and capsules) is often considered a safe option. However, the literature shows a lack of clear information and medical personnel's knowledge about suitable drug formulations.…”

Section: The Need For Guidelines and Trainingmentioning

confidence: 99%

Solid oral medications' suitability for use in enteral feeding tubes

Teder

Jõhvik

Meos

et al. 2021

Nursing in Critical Care

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Background: There is a lack of specific data about the efficacy and safety of medications administered via feeding tubes, although there is a general awareness that not all drug formulations are suitable.Aims and objectives: To overview the current situation with solid medications administered through feeding tubes in the Tartu University Hospital intensive care units. To evaluate the availability of information on the suitability of drug formulations for administration via feeding tubes.Design: This was a descriptive retrospective document analysis study.Methods: During visits to the intensive care units, medication data for current patients were collected from paper medical charts and nurses. In addition, package information leaflets, summaries of product characteristics, and two practical handbooks were used for evaluating the medicines' suitability for administration via feeding tubes. A request for information was also sent to manufacturers or marketing authorization holders.Results: In 3 months, data were collected from 113 intensive care patients' medical charts. A total of 306 medication administrations via feeding tubes were documented and analysed, 67% of which were solid oral dosage forms. Exactly 91.2% of these were conventional tablets. After the analysis of information availability, 88% of the medications were classified as suitable for administration via feeding tubes, but only 48% had the manufacturer-provided information. Conclusion:This study showed that the information about the suitability of formulations administration through a feeding tube is not readily available for almost half of the medications. The manufacturers seem to have the relevant information, but it is not always added to their medications' official information, putting these patients at higher risk for errors.Relevance to Clinical Practice: This study shows that if there is no clear statement about administration through feeding tubes on official manufacturers' information,

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“…5 This knowledge gap has only grown with the development of novel agents, a recent study finding that as of July 2019, only 38% of available OODs had information related to enteral tube administration. 6 Given the relative absence of formal guidance for the compounding/administration of alternative liquid formulations, pharmacist expertise related to drug formulation properties, pharmacokinetics, compounding, and regulatory guidance may be leveraged to develop effective, safe practice standards. In particular, pharmacists may extrapolate from preclinical drug pharmacokinetic information to evaluate relative safety of manipulating solid dosage formulations and to evaluate extemporaneous product stability.…”

Section: Introductionmentioning

confidence: 99%

“…3,7 Application of regulatory guidance such as United States Pharmacopeia (USP) 800 to policies and procedures also promotes safe handling of extemporaneous products at every level of the medication use process (MUP). 6,8,9 The current MUP for compounding extemporaneous liquid OODs from commercial products for inpatient requests at Oregon Health & Science University (OHSU) is described in Figure 1. Previously, in the absence of a complete list of available OODs and related compounding recipes, urgent drug information reviews were conducted in the event of no prior information within the OHSU compounding repository.…”

Section: Introductionmentioning

confidence: 99%

Medication use process and assessment of extemporaneous compounding and alternative routes of administration of oral oncology drugs: Guidance for clinical and oncology pharmacists

Cohen

Lee

Markham

et al. 2022

J Am Coll Clin Pharm

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Cancer treatment is evolving. Oral formulations offer potentially more convenient, effective alternatives to conventional chemotherapy for many cancers. An appealing aspect of oral antineoplastic agents is their relative ease of administration; unfortunately, patients may have difficulty swallowing the tablets or capsules. This shift towards oral administration and the accompanying issues around oral medication adherence highlights the need to assess the safety and feasibility of delivery methods for patients unable to swallow solid dosage forms. A new medication‐use process (MUP) was created to facilitate extemporaneous compounding of oral oncology drugs (OOD). Systematic review consisting of tertiary resources, drug manufacturers, and primary literature was performed to identify information related to extemporaneous compounding or alternative routes of administration for a predetermined list of OODs. A single‐center retrospective review was conducted of patients receiving liquid formulations of OODs to characterize institutional experience. Overall, 116 OODs were reviewed. The majority of OODs had information describing extemporaneous compounding or alternative routes of administration (31% with commercial liquid formulations available or information in tertiary resources; 33% with off‐label manufacturer information or case reports) while 36% had no data. The MUP included three compounding workflows to account for available solid dosage formulations (tablet, hard capsule, gelatin capsule) and creation of an electronic health record order template. Retrospective review identified 41 patients who received compounded liquid formulations of 14 OODs for 13 indications. Liquid OODs were used for a median of 3‐5 days. None of the 41 patients experienced discernable safety or overt effectiveness concerns readily attributed to use of liquid OODs. Implementation of a novel MUP and systematic review of OODs aids the pharmacist in standardizing institutional practice and mitigates risks associated with extemporaneous liquid formulations of OODs facilitating medication delivery of new agents to patients unable to swallow solid dosage forms.

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Enteral tube administration of oral chemotherapy drugs

Cited by 19 publications

References 43 publications

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Solid oral medications' suitability for use in enteral feeding tubes

Medication use process and assessment of extemporaneous compounding and alternative routes of administration of oral oncology drugs: Guidance for clinical and oncology pharmacists

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