title: Impact of direct drug delivery via gastric access devices.
abstract: BACKGROUND
  Gastric access devices such as nasogastric tubes and gastrostomy tubes are increasingly being used in clinical practice to provide both short- and long-term nutrition support therapy. Increasingly these devices are being utilized to help deliver oral medications, where swallowing is impaired. This concomitant administration of medications and enteral formulas could derive potential benefits in regard to time and cost; however, uncertainty exists regarding potential drug and nutrient interactions and the influence this may have on both safety and efficacy.
  
  
  METHODS
  This article provides an overview of the differing gastric access devices used in clinical practice and evaluates the evidence base for using oral medications via these routes. Alternative methods of drug administration are discussed, alongside common drug nutrient interactions and potential complications.
  
  
  CONCLUSIONS
  Delivering medications via gastric access devices can be performed safely; however, careful consideration needs to be made regarding tube and patient influences, alongside drug-nutrient interactions. Improving practice in this area in the future necessitates enhancement of an evidence base to substantiate the safety of drug delivery via gastric access devices and improvement in education among healthcare professionals about the potential problems.
authors.affiliation: Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Gastroenterology and Liver Unit , Glossop Road, Sheffield, S10 2JF , UK +44114 2261179 ; +44114 2712692 ; matthew.kurien@sth.nhs.uk.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kurien
authors.forename: Hugo
authors.initials: H
authors.lastname: Penny
authors.forename: David S
authors.initials: DS
authors.lastname: Sanders
mesh_terms: D002626:Chemistry, Pharmaceutical; D004355:Drug Stability; D004750:Enteral Nutrition / Q000379:methods*; D018565:Food-Drug Interactions; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000737:chemistry / Q000493:pharmacokinetics
chemical_list: D055553:Prescription Drugs
keywords: complications; drug delivery; enteral feeding; gastric access devices; gastrostomy; nasogastric tubes