title: Quantitative analysis of drug losses administered via nasogastric tube--In vitro study.
abstract: OBJECTIVE
  Drug administration through nasogastric tube (NGT) is a standard practice but the real amount of the delivered drug is unknown. Therefore, we designed a study to determine the losses of various dosage forms administered by different methods through NGT.
  
  
  METHODS
  In vitro model was used. Five different administration methods (A-E) and six dosage forms (simple compressed tablets - T/S; film coated tablets - T/FC; enteric coated tablets - T/EC; capsules with powder filling - C/P; capsules containing extended release pellets - C/ER; capsules containing gastro-resistant pellets - C/GR) were investigated. Measurement was repeated six times for each drug-method combination. The overall losses were determined by gravimetry. In method A partial losses associated with each step of drug administration were also determined.
  
  
  RESULTS
  Significant drug losses were measured (4-38%). Only methods A (crushing-beaker-syringe-water-NGT) and B (crushing-water-syringe-NGT) were suitable for administration of all tested dosage forms. Method B proved the most effective for all kinds of tablets and C/GR (p<0.05) and tended to be more effective also for C/ER (p=0.052) compared to method A. C/P showed minimal losses for both tested methods (B and E). Flushing of the drug through NGT causes major losses during drug administration compared to crushing and transfer (p<0.05). All methods for intact pellets (C-E) were found inappropriate for clinical practice due to NGT clogging.
  
  
  CONCLUSIONS
  Choosing a suitable administration method can significantly affect the amount of drugs delivered through NGT.
authors.affiliation: Department of Anaesthesiology and Intensive Care, St. Anne's University Hospital Brno, Brno, Czech Republic; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Adriana
authors.initials: A
authors.lastname: Ruzsíková
authors.affiliation: Department of Anaesthesiology and Intensive Care, St. Anne's University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Součková
authors.affiliation: Department of Anaesthesiology and Intensive Care, St. Anne's University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Suk
authors.affiliation: Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.
authors.forename: Radka
authors.initials: R
authors.lastname: Opatřilová
authors.affiliation: Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.
authors.forename: Martina
authors.initials: M
authors.lastname: Kejdušová
authors.affiliation: Department of Anaesthesiology and Intensive Care, St. Anne's University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic. Electronic address: vladimir.sramek@fnusa.cz.
authors.forename: Vladimír
authors.initials: V
authors.lastname: Šrámek
mesh_terms: D002214:Capsules / Q000008:administration & dosage / Q000737:chemistry; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000737:chemistry; D007441:Intubation, Gastrointestinal; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000737:chemistry*; D013607:Tablets / Q000008:administration & dosage / Q000737:chemistry
chemical_list: D002214:Capsules; D003692:Delayed-Action Preparations; D004364:Pharmaceutical Preparations; D013607:Tablets
keywords: Dosage forms; Drug administration; Enteral feeding; Intensive care; Nasogastric tube