Guidelines for Drug Administration During Enteral Feeding

The challenges of innovation in the organization of home enteral tube feeding

The number of patients discharged from hospital who need home enteral tube feeding has been increasing steadily in the UK. Arrangements for support of these patients is extremely variable. The unsatisfactory arrangements for home enteral tube feeding which existed in Avon in 1996 prompted an innovative reorganization. On the basis of that experience, this review examines the key issues involved and the questions to be considered, which may be of benefit to other trusts faced with similar challenges.

A Guide to Enteral Drug Administration in Palliative Care

Enternal feeding is indicated in patients unable to ingest sufficient nutrients but whose gastrointestinal function is adequate for digestion and absorption. Indications in palliative care include patients with radical esophageal surgery, upper gastrointestinal tract obstruction, anorexia, and dysphagia. As the oral route is the preferred method of palliative drug delivery, the enternal feeding tube can become an important tool for drug administration. A number of questions must be asked before a drug is considered for enteral administration. Firstly, is the drug in a suitable dosage form for administration? If not, can a different dosage form (or drug) be substituted or can the physical form of the original product be altered? Secondly, is the drug compatible with the enteral feed? Finally, are there any complicating factors that may affect drug absorption or clearance? This review attempts to answer these questions, provide easily understood guidelines for the successful enteral administration of medications, and discuss clinical implications for palliative care.