[Update] Crushing/Simple Suspension Feasibility Checker: Increased to 440 Drugs
I have updated the "Crushing/Simple Suspension Feasibility Checker" that I released the other day.
The number of listed items has been increased from 386 to 440 drugs. This is an addition of about 60 drugs since the last time.
What kind of tool is this in the first place?
When you are in charge of patients who require tube feeding or have difficulty swallowing, you frequently need to check, "Can this medication be crushed?" or "Is the simple suspension method feasible?"
I wanted to reduce the hassle of reopening a handbook every time, so I created a tool that you can quickly check on your smartphone.
You can search by brand name or generic name, in either hiragana or katakana. For each drug, it displays the feasibility of "crushing" and "simple suspension" in three levels: feasible, conditional, or not feasible. It also includes the reason why (e.g., destruction of sustained-release properties, inactivation of enteric coating, blockage due to swelling, exposure risk) and, if necessary, alternatives.
What has been added this time
I focused on filling in drugs that are commonly prescribed, with the goal of reducing instances where you "looked it up on the job but it wasn't listed."
Basic internal medicine drugs I have added a full range of drugs frequently used in outpatient settings, such as NSAIDs (Hyphen, Mobic, Soleton, Nikisan, etc.), H2 blockers (Tagamet, Zantac, Asinon), and anti-allergy drugs (Desalex, Allegion, Zaditen).
Antibiotics In response to requests, I have added Cefaclor (Kefral), as well as Banan, Tomiron, Farom, Dalacin, and others. I have also noted that Dalacin has an extremely bitter taste when the capsule is removed.
Intestinal regulators/Antidiarrheals Bio-Three, Rack-B, Biofermin R, Adsorbin, Tannalbin, etc. I have included operational notes for Adsorbin and Tannalbin, such as being careful about blockages because they tend to settle.
10 Kampo prescriptions I have individually listed Kakkonto, Yokukansan, Rikkunshito, Hochuekkito, Shakuyakukanzoto, Bakumondoto, Goreisan, Hangeshashinto, Goshajinkigan, and Junchoto.
Kampo medicines are typical examples that easily clog tubes during administration. Since they may remain undissolved even in 55°C warm water, I have written practical handling methods for each prescription, such as "knead with a small amount of hot water before diluting."
Drugs requiring caution regarding blockage/exposure Colebine and Questran swell with moisture, so there is a risk of clogging the tube if suspended. Tigason has teratogenicity, and exposure itself from opening or crushing it is a problem. I prioritized including these "drugs that can lead to accidents if you don't know about them."
Notes on use
This tool is an unofficial information tool intended for study and professional reference. It does not guarantee or recommend the feasibility of administration to any specific patient.
The judgments are reference information based on general knowledge such as the "Handbook for Oral Medication and Tube Feeding." Even with the same ingredients, feasibility and precautions may change depending on the dosage form, brand/generic, manufacturer, or product revision.
Even for drugs marked as "feasible," please follow your facility's procedures for techniques such as suspension temperature, time, tube diameter, physical/chemical compatibility, and post-administration flushing. Since anticancer drugs, hormones, and immunosuppressants involve considerations regarding exposure prevention, their feasibility must be judged according to each facility's standards.
Final decisions must always be made after checking the latest package inserts, interview forms, and the manufacturer, as well as consulting with the prescribing physician.
Link
If you have any feedback such as "this drug is missing" or "this part should be corrected like this," please let me know. I would like to continue improving it little by little.