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Helping The Medicine Go Down, Or Crushing Its Effectiveness?
 
# 1 : Monday 24-9-2012 @ 17:03
 
 
Recent research has raised worrying doubts about the safety of a very common practice: powderizing the pills to help the medecine go down easier.

Parents may crush a pill and mix it with yogurt to help a child swallow it.
No big deal?

Now imagine a nursing home.
Imagine the different pills of the same patient crushed with he same spoon, and the active ingredients of one interacting with the other.
Imagine the crushed pills' ingredients interacting with the mash or the yogurt they are mixed with.
Imagine the same tools used to crush and mix the medicines of different patients.

The think about how crushing the pills can change the way they are absorbed: some pills are designed to release their active ingredients slowly, some are designed to avoid releasing in the stomach. Imagine the under-dosages or over-dosages that could result.

Is that the next sanitary scandal to come?
How long before guidelines are issued on which medicines can be crushed, and which ones cannot. Or what should be prescribed to a patient who cannot swallow pill due to physical or psychological barriers?

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# 2 : Monday 24-9-2012 @ 17:24
 
 
Someone said :

Imagine the crushed pills' ingredients interacting with the mash or the yogurt they are mixed with.
Imagine the same tools used to crush and mix the medicines of different patients

Can you explain what you mean by this? Im not sure ive heard of any medications that are contraindicated with yogurt.

And as for any residue left on the spoon, im not sure what drugs you are talking about but they would have to be active, and dangerous, in seriously small amounts.
Is there proof that this even happens?

How long before guidelines are issued on which medicines can be crushed, and which ones cannot.

Issued to who?
Doctors and medication instructions already give this info. Slow release tablets are nothing new.

Or what should be prescribed to a patient who cannot swallow pill due to physical or psychological barriers?

Oral liguid, sublingual tablets, injections, suppository, patches.
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# 3 : Monday 24-9-2012 @ 17:28
 
 
Sakura was saying recently that grinding up tablets can limit the effectiveness of medication, he explained why but I can't quite remember what he said!
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# 4 : Monday 24-9-2012 @ 17:48
 
 
Someone said :
Sakura was saying recently that grinding up tablets can limit the effectiveness of medication, he explained why but I can't quite remember what he said!

It depends on the medication, in some cases it will make it stronger, in some it will make it ineffective, with most it wont make any difference. It depends what it is and what form it is in.
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# 5 : Monday 24-9-2012 @ 17:49
 
 
When I was very young my parents used strawberry jam in which to hide the pill. Of course one quickly associates a spoonful of strawberry jam with taking medicine.
To this day I can't stand strawberry jam.
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# 6 : Monday 24-9-2012 @ 18:12
 
 
There were a lot of "imagine"s in the OP way too many to work out the question.
There are already alternatives to most oral prescriptions as many people cannot swallow tablets but can still take medicine.
As for the "oh no won't someone think of the children" whatif's the same crushing spoon is used for other people, surely it would make sense that if a spoon was used for crushing then that spoon would be used for feeding the said person.
Imagine if most of the medicine we are given is just a placebo to get us out of the doctors surgery.
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# 7 : Monday 24-9-2012 @ 18:14
 
 
Just wash your cutlery properly, problem solved!
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# 8 : Monday 24-9-2012 @ 18:40
 
 
I want to like Penny's post, but instead I'll say "exactly"
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# 9 : Monday 24-9-2012 @ 19:07
 
 
Someone said :
I want to like Penny's post, but instead I'll say "exactly"

Reply
 
# 10 : Friday 30-11-2012 @ 02:13
 
 
Someone said :
Just wash your cutlery properly, problem solved!

Tell that to nursery home staff.
When they give medicines, it has to be done within a time frame that does not give them that luxury.

On a side note. It turns out that more medicine than every come with a very very strong warning about administrating them with Grapefruits: these fruits multiply the effects of the medicines by 20 and result in overdoses!
So in doubt: swallow you medicines with as glass of water or of orange juice,l and avoid grapefruit juice...
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# 11 : Friday 30-11-2012 @ 02:18
 
 
Someone said :

Tell that to nursery home staff.
When they give medicines, it has to be done within a time frame that does not give them that luxury.


On a side note. It turns out that more medicine than every come with a very very strong warning about administrating them with Grapefruits: these fruits multiply the effects of the medicines by 20 and result in overdoses!
So in doubt: swallow you medicines with as glass of water or of orange juice,l and avoid grapefruit juice...

If they had a clean spoon for each of the patients starting their round and just place them in the dishwasher afterwards, problem solved
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# 12 : Friday 30-11-2012 @ 02:22
 
 
Someone said :

If they had a clean spoon for each of the patients starting their round and just place them in the dishwasher afterwards, problem solved

They usually crush all the meds in a row.
Not one at a time as they give them.
And even if they did, that requires 2 hard spoons.
The realities of caring for more than 1 person are far remove from the glamor of TV medicine.
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# 13 : Friday 30-11-2012 @ 02:23
 
 
Grapefruit juice(white) inhibits certain enzymes (CYP3A4,CYP3A5) which help to break down and metabolize certain drugs (mostly opiates and other pain killers)
This trick has been used by recreational drug users for years.
With new drugs coming on the market all the time its something that the makers really should be looking into before releasing them, so they can attach warnings.
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# 14 : Friday 30-11-2012 @ 02:24
 
 
Someone said :

They usually crush all the meds in a row.
Not one at a time as they give them.
And even if they did, that requires 2 hard spoons.
The realities of caring for more than 1 person are far remove from the glamor of TV medicine.

But the home is getting between €700 to €1000 per week to look after each resident.? Surely that should be enough to pay for washing enough spoons.?
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# 15 : Friday 30-11-2012 @ 12:24
 
 
Someone said :

But the home is getting between €700 to €1000 per week to look after each resident.? Surely that should be enough to pay for washing enough spoons.?

And you think the home is linking the money they get to the quality of the treatments?
God bless
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