When a patient is NBM it is important to consider how medications can be administered in consultation with the pharmacist and medical staff.
As Connie is NBM this would indicate that an NG tube should be passed. However, the Speech and Language Therapist will assess her swallowing ability later today. The decision to pass an NG tube will be made following this assessment.
Is the medication essential? Discussion and judgement must be used to consider if a medication is essential. When prescribing /de-prescribing, care should be taken to minimise harm and optimise the benefit. Advice on de-prescribing is available on the Scottish Government Poly-pharmacy Model of Care Group which contains a 7 step process for the review of medications. Connie should be involved with the discussions about her medications. The benefits and risks of medications should be clearly explained.
Does the medication interact with other medications or feed? Some medications can be affected by food and interactions with other medications, e.g. Antiplatelet effect can be increased by drinking grapefruit juice. Anticoagulants effectiveness can be reduced if large amounts of Vitamin K are consumed. The Professional guidance on the safe and secure handling of medicines states that the right drug, right route, right time, right dose and the right patient are considered before giving any medication. It is the responsibility of the health professional to ensure that Connie is aware of these interactions and is given the correct advice on managing her medication.
Does the medication come in a suitable formulation for administration? Tablets should not be crushed unless it is stated in the licence for use. Where possible medication should be given in an alternative form or via a different route e.g. Aspirin can be given rectally or in a soluble form via a tube if the person is unable to swallow / is being tube fed. Adherence to national guidelines and local formularies for administration is essential. Any issues should be discussed /advised by the ward/locality pharmacist.
Consider the following:
- Is the medication essential?
- Does the medication interact with other medications or foods?
- Does the medication come in a suitable formulation for administrating?
Page last reviewed: 12 Nov 2021
