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How to adminster medication with feeding tube
My peg tube was installed two months ago and I am using the peg tube the majority of my meals. I now need to start taking my medication through the peg tube. I have done the primary work of contacting and identify the medications that can be crushed or have a liquid formulation. Now preparing for the feeding tube is where I am having problems. How to videos and litrature has you preparing and adminstering one medication at a time and cleaning utensils and peg tube after each medication. With blood pressure medication, ALS medication, sinus medication and vitamines I take fifteen pills a day and to crush, mix, adminster, flush and clean between each medication would take all day. How does the ALS community prepare and administer medication to PALS with a feeding tube? What are the best tools and practices for the crushing, mixing, administering and flushing of medication?
I read through the responses on Tips about feeding tubes and several of the post mention using feeding tube for medication but fail to identify the how. My pharmatist says that manufactures provide very little information about the crushing and mixing of medication for administering through a feeding tube. Any helpful hints would be appreciated.
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5 Replies
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James, you are right – – there’s lots of information recommending breaking up medication for a feeding tube – – but nothing on “how.” I hope our form members will share tips on what they do.
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James, my solution to the same problem is as follows (I got my PEG in March).
I take Carnation Essentials as the basis for my “breakfast” and use a Ninja smoothie / blender to mix things up.
My supplements include 40gr of protein powder, 12gr of fiber, as well as several capsules, tablets, and gel caps in addition to the Carnation product.
I was given the same instruction of one item at a time with cleanings in between. This is what I do instead.
Using an 18 or 24 ounce smoothie cup,
1) I add all of the powdered items (protein, fiber, Carnation Essentials
2) I bought an electric pill grinder (spice or coffee grinder will work) and pulverize all of the tablets and add them to the cup
3) I “disassemble” any capsules with dry contents and add the contents to the cup
4) gel caps get added to the cup whole
5) finally for this step, I add 8 ounces of whole milk (the carnation directions say skim, but I want the extra calories).
I run this on the smoothie setting to blend everything together.
Following this, I add 1/2 banana and 3 – 4 ounces of a suitable fruit, both frozen. (e.g., strawberries for strawberry, with vanilla it can be blueberries, peaches, cherries, etc.) I run another smoothie cycle to blend this.
I strain this through a fine mesh strainer to remove seeds and any remaining gel cap solid bits into a 12 ounce smoothie cup and refrigerate.
I usually make a week’s worth of “breakfast” on Sunday. Note that I switched to a 32 ounce smoothie cup to start and doubled everything so I get two 12 ounce servings per make up – saves a little time.
One thing to note is that I cleared this with my nutritionist before I did it and my other “meals” are Jevity and/or 2CAL HN formulas both tube fed.
I can still take some things by mouth, so my ‘breakfast’ mix allows me to start drinking it, then switch to tube feed if I get tired of the time it is taking – or just tube feed, my choice.
You should also blend and restrain the mix before taking it – it warms it up some and removes other small bits that may have been missed.
I am using the bolus method of tube feeding with a 60mL syringe and each “meal” is 350 – 400mL with 100mL water flush before and after.
That’s probably more “how” than you wanted, but hope it helps. Good luck! -
Check with pharmacist as to what medications that are crushed can be combined.
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Not necessary to administer one med at a time. My wife was diagnosed five years ago and has used a feeding tube since then. All meds are crushed or liquid. Morning feeding is 4 meds, afternoon feeding is 3 meds/vitamins, evening is 4 meds/vitamins and bedtime is 4 meds. All feedings include 60cc water before and after. She also gets formula for nutrition through the feeding tube, administered by gravity feed.
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We administer the AM formula, wait about 30 minutes & give prescriptions, wait 30 minutes & give supplements. For each prescriptions & supplements we use a total of 8 Oz of lukewarm water; a little to dissolve the medication and the rest to flush. We do another formula before noon. He has some prescriptions to take at noon or 1:00 to 2:00 depending on how late we got started. We leave the afternoons free. Start night formula, prescriptions, supplements, laxative, sedatives about 5pm.
All is done by gravity feed. We use the “silent knight” crusher from Amazon. I love it. I crush and/or mix all prescriptions together, all supplements together.
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Just a few things to add. My husband has had his PEG tube since 2019. After checking, I have been administering his crushed meds together. I’m a huge fan of the Silent Knight pill crusher that I bought on Amazon. For those still able to do their own feeds, I recommend the Buckwheat feeding tube holder (www.feeding tube holder.com). Also a video on YouTube. We purchased the Buckwheat Armie that has an adjustable arm and attached to the kitchen table with a C-clamp. For a very long while this enabled him to do his own feeds. I have since donated to our ALS clinic. By the way, it was designed by a man whose father (nicknamed Buckwheat) had ALS and struggled to feed himself. One more thing to share. The Oley Foundation is a home nutrition therapy advocacy group with loads of information, resources, and help for people who require tube or IV feedings. You can sign up for newsletters as well as checking out their website. Hope these suggestions will be helpful.
Gail
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All good advice and thank you, everyone, for sharing – – these will help other pALS facing the same challenges.
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My husband had it a month ago. No one give me any education and even I asked the doctor. He said that the ALS asociation was going to contact me, but not. I ask to the ALS clinic and they give me a brochure. The good this was that I work as nurse assistant for year in a hospital, so I know how to do it. I give him, fits his Radicava,an hour later relyvrio before meals, supplements, some solid food. One hour later his vitamins all together, and flushed. Until now not problem, and I hope continue with out it.
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