However, not every pill can be crushed as it may affect the absorption of the drug and decrease its intended effect. If a pill can be crushed, there is a right way and wrong way of doing this. Here is a primer that can help. Not every pill can be crushed. There are times when doing so can decrease the drug's effectiveness or increase the risk of side effects and overdosing.
The types of pills below should not be crushed. Enteric-coated drugs should never be crushed, broken, or chewed. The pills are coated to reduce stomach irritation. The special coating is gradually dissolved as it passes through the stomach so that the drug begins to be released as it passes into the intestine. Enteric-coated tablets often have "-EN" for enteric or "-EC" enteric-coated tagged at the end of the brand name. Some drugs are also enteric-coated to avoid teeth staining or to prevent stomach acids from destroying the drug.
If not swallowed whole, these drugs may be less effective and more likely to cause side effects. You can often tell that a pill is enteric-coated when it is has a slight sheen. If in doubt, call your pharmacist. Sustained-release drugs are similar to enteric-coated drugs in that they are meant to be absorbed slowly rather than all at once.
These products typically have brand names that end with "-CR" controlled-release , "-DA" delayed-action , and "-ER" or "-XR" extended-release , among others. Sustained-release medications are designed to deliver the drug over a long period of time. Crushing the pill causes the drug to be released all at once.
This reduces its effectiveness as the drug concentration will be high at first and then drop quickly so that there is no more left in the body. The initial high levels can also increase the risk or severity of side effects. You should never crush narcotics , also known as opioids. These drugs have a high potential for drug addiction and are designed to be released at a controlled, steady rate.
The rapid release of opioids in the bloodstream can intensify the effects of the drug, including pain relief and feelings of euphoria. This can increase the risk of a drug overdose. It can also increase the risk of addiction as the body becomes accustomed to the rapid burst of the drug and requires more and more to achieve the same effects.
Some of the more commonly prescribed opioids include:. Not all pills can be crushed. These include pills that are enteric-coated or sustained-release. Opioid drugs especially should never be crushed as it increase the risk of addiction and overdose.
Many pharmacies place a sticker on pill packaging stating they that should not be crushed. If you don't see a warning label, ask your doctor or pharmacist before crushing any pill.
If a pill can be crushed, there are three safe and effective ways to do this:. Some people are tempted to crush their pills by placing them in a plastic bag and hitting them with a hammer or mallet. But this is a problem for several reasons:. It is also not a good idea to mix crushed pills. If you need to crush two or more pills, each should be crushed separately and taken separately.
In addition to crushing pills currently, you need to find out which foods you can or cannot mix the medication with. Many drugs can be mixed safely with things like applesauce, fruit juice, pudding, or water, but not just any food. Certain foods can reduce the effectiveness of the crushed drug. For example, grapefruit juice can significantly affect how a drug is absorbed and metabolized broken down or activated in the body, altering its levels in the bloodstream.
Public Citizen advocates Medicare for All, stronger oversight of dangerous doctors and safe clinical trials. For decades, we have fought for progressive alternatives that benefit people and the planet. The climate crisis is the challenge of our time. We can fix it with solutions that will make us healthier and more economically secure.
We must act quickly to make our economy run on renewable power — and ensure that disadvantaged families and displaced workers share equitably in the new economy.
We also must fight the corrupting power of fossil fuel companies and ensure that energy regulators are effective and publicly accountable. Litigation can remedy or deter wrongdoing, impact policy and meaningfully slow abuses of power. Whether suing on behalf of our members to ensure the honest functioning of government, or representing individual consumers seeking redress in court, our litigation draws on our expertise in administrative law, constitutional law, and government transparency.
Health Letter , July Some patients find it difficult or impossible to swallow large tablets or capsules. To cope with this problem, patients, caregivers and health care providers frequently crush tablets or open capsules and sprinkle the resulting powder, fragments or granules into food or liquids.
Some patients also may resort to chewing on the pills or capsules before swallowing. However, an important review published in Prescrire International warned that many medicines available in tablet or capsule form are not supposed to be crushed, opened or chewed before swallowing — and that doing so may have serious, sometimes deadly, consequences.
Oral medications available in tablet or capsule form contain one or more active ingredients — the actual drug intended to treat a particular disease or condition — and several inactive ingredients. Inactive ingredients include coating materials, flavorings, dyes and binders that hold tablets or granules from capsules together.
Drug companies use complex manufacturing techniques to combine these ingredients into final products that are designed to release their active ingredients at a specific rate and in a specific location within the digestive tract, such as the stomach or the small intestine. For example, some uncoated, immediate-release tablets are designed to disintegrate quickly in the stomach, whereupon the active ingredients are rapidly absorbed into the bloodstream.
For these drugs to work, the active ingredients must be able to withstand exposure to the strong acid found in the stomach before they are absorbed.
For other drugs containing active ingredients that would otherwise be broken down by stomach acid, manufacturers have designed tablets and capsules with acid-resistant coatings often called enteric coatings. Only when these tablets or capsules move from the stomach to the small intestine will the coating dissolve, allowing release of the active ingredients. In addition, many drugs in tablet or capsule form are designed to release their active ingredients even more slowly, over a period of 12 to 24 hours as the tablets or granules from the capsule pass through the small intestine.
This sustained-release also called controlled-release, long-acting and extended-release design provides the convenience of once- or twice-daily dosing and minimizes the variation in the amount of drug in the blood over the course of a day. This design can improve patient compliance and drug effectiveness while decreasing the risk of adverse effects. Crushing a tablet, opening a capsule or chewing either of these can circumvent many of the protective design features intended to control when and where a drug is released in the digestive tract.
Depending on the drug, this can result in overdosing, underdosing or direct toxic injury to the lining of the mouth, stomach or intestines. The Prescrire International review highlighted examples of each of these potentially dangerous circumstances for several commonly used drugs. For some drugs, crushing, chewing or opening a tablet or capsule before swallowing can cause the rapid absorption of a large amount of the drug, potentially resulting in an overdose.
Digoxin is approved by the Food and Drug Administration FDA to treat heart failure and to slow the heart rate in patients who develop atrial fibrillation, a common abnormal heart rhythm characterized by an irregular and often rapid heart rate.
According to the authors of the Prescrire International review, crushing digoxin tablets before swallowing may increase the risk of other dangerous abnormal heart rhythms. Likewise, the authors noted that opening capsules containing the oral anticoagulant dabigatran PRADAXA will increase the amount of drug that is absorbed, exposing the patient to a greater risk of serious bleeding. Sustained-release drugs also should not be crushed or chewed before swallowing because doing so will cause the dangerously rapid absorption of a large dose that was intended to be released slowly over many hours.
Medication presented in capsule form is designed to be swallowed. Do not chew, break, crush, or open a capsule to pour out the medication, unless a healthcare professional has advised you to. Some pills may be harmful if crushed or opened. If in doubt seek professional medical guidance.
They can be taken orally or as a suppository. A tablet is usually in the form of flat tablets and a capsule is almost cylindrical. Tablets can be cut into two, whereas capsules cannot be cut into two. A capsule consists of powder or jelly enclosed in a dissolvable gelatin container.
A tablet is a compressed powder in solid form. Tablets are often coated with sugar or similar substances, which means that the drug contained in it will not immediately enter the blood-stream. But, the drug in the capsules is known to enter the blood-stream immediately — as soon as the capsule dissolves. Tablets are known to be less expensive when compared to capsules. Tablets are also known to have more shelf life and retain their potential for a longer period than the capsules.
Moreover, tablets are available in different sizes and shapes. The only drawback that can be seen with tablets is that large tablets can be hard to swallow. The only way to to take a larger tablet, if you have trouble swallowing, is to break it or crush it to powder. Be sure you always consult with your doctor or medical professional before breaking or crushing a tablet. As a result, the swallowing of capsules can often be difficult for some people.
In patients who experience such difficulty, it is suggested that they try leaning forward when swallowing, as this has been found to assist.
It may be necessary to reassure patients about this technique as they may initially find it unnatural to execute.
0コメント