When a patient is prescribed a timedrelease medication such as glucotrol xl or glucophage xr, clinicians need to ensure that the patients understand that they should not crush, chew, or cut these pills. By default, do not crush also means that the drug is not to be halved, unless stated otherwise. Oral dosage forms that should not be crushed do not crush. I always try to get the med in liquid form if possible for gtubes instead of crushing that way you are not battling the bits that stick to the inside of the cup andor clumping that can occur. Antiretroviral crushdo not crush list agents open capsule crush tablet liquid form other formulations notes nucleoside reverse transcriptase inhibitors nrtis abacavir abc ziagen1 yes yes no add to small amount of semisolid food or liquid. Guide to medication crushing medsask university of saskatchewan. College of pharmacy and nutrition university of saskatchewan. Crushing guide for oral medication in residents with. Alex barker is the founder of the happy pharmd, which helps pharmacists create an inspiring career, break free from. Dabigatran capsules should therefore not be broken. Resource library institute for safe medication practices. The united states, united kingdom, and australia have developed resources to guide healthcare professionals when considering altering solid dosage forms.
Mar 31, 2020 medications that should not be crushed because of their special pharmaceutical formulations or characteristics this list has been adapted with permission from echaiz, t a ed oral dosage note sublingual tablet do not suck, chew, or swallow whole drug institute for safe medication practices. Enteric coated products do not crush, break or chew. Take this quiz to test your knowledge of medication administration. Institute for safe medication practices ismps list of error. For information, ordering, and availability of wall charts, books, and other publications use the categories links shown to the left. Federal register niosh list of antineoplastic and other. Feb 19, 2014 maybe its a state rule, but we are not supposed to crush meds without a doctors order. In that regard, we are providing the link to the institute for safe medication practices ismp most recently updated version of its list of oral medications that should not be crushed. May, 2018 list of do not pay insurance 2018 jcaho do not use list 2016 how do i bill botox injections game for joint commission do not use abbreviation list lsiting of revenue codes that do not require hcpcs codes when do nyc retirees get thier 2016 medicare b reimbursement checks from uft joint commission do not use abbreviations 2016. Ismp survey shows text messaging in healthcare often runs. The following are some general guidelines for doing so. Ismp is the only nonprofit 501c3 organization devoted entirely to preventing medication errors.
Do not break, open, or chew before administration the institute for safe medication practices ismp received a report from a hospital regarding an adverse drug event that oc curred as a result of inappropriate admin istration of dabigatran pradaxa to a patient. Take the medication with a full glass of water and do notbreak, crush, chew, or empty. A ct scan was delayed for a patient because the nurse did not see the texted order. Oct 08, 2008 i always try to get the med in liquid form if possible for gtubes instead of crushing that way you are not battling the bits that stick to the inside of the cup andor clumping that can occur. Consume immediately didanosine ddi videx ec2 no yes powder. Pharmaceutical companies that do not supply a range of halfdose and quarterdose versions of timerelease tablets can make it difficult for patients to be slowly tapered. Oral dosage forms that should not be crushed john f. If anyone has gone through the hassle of typing all of this information out on their own, i would gladly tip for a copy of the pdf. Drug safety considerations for using non vka oral anticoagulants zachary r. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Dabigatran capsulepradaxa do not crush, chew or open4 bioavailability increases by 75% when pellets are taken without the capsule shell1 dexamethasone tabletdexmethsone disperse and give within 15min, with or soon after food4 diazepam arrowdiazepam tablet can be divided into equal doses. Do not use parenteral syringes to administer drugs into an enteral tube or by the oral route. If you or a loved one have experienced a mistake with a medication or have a safety concern to share with others, we would like to hear from you.
Crushing pills on long term care facilities patient. Page 1 of 15 drug product active ingredient 2 dosage form reasonscomments 3accutane isotretinoin capsule mucous membrane irritant aciphex rabeprazole tablet slowrelease actiq fentanyl lozenge slowrelease note. Institute for safe medication practices ismps list of errorprone abbreviations, symbols, and dose designations abbreviations intended meaning misinterpretation correction. Apr 18, 2019 in that regard, we are providing the link to the institute for safe medication practices ismp most recently updated version of its list of oral medications that should not be crushed.
Qd us qod every day every other day qd and qod have been mistaken for each other, or as qid. Abbreviations with a double asterisk are also included on the joint commission on accreditation of healthcare organizations minimum list of dangerous abbreviations, acronyms, and symbols that must be included on an organizations do not use list effective january 1, 2004. Oral dosage forms that should not be crushed medications that should not be crushed because of their special pharmaceutical formulations or characteristics. These medications are formulated to dissolve in the intestine to lessen gastric irritation, to prevent irritation of mouth, to prevent staining of teeth and oral mucosa or to prevent stomach acid from destroying the drug. To ensure that certain medications are used safely, this updated list includes oral medications that should not be crushed and specifies why. Ismp do not crush list 2018 pdf saw a few people had. The list of oral dosage forms that should not be crushed, commonly referred to as the do not crush list, contains medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as oral dosage forms that are sustainedrelease in nature. Oral dosage forms that should not be crushed consumer med. Medication safety in seconds february 2015 volume 5 issue 2.
Use oral syringes, which are designed to not allow connection to parenteral tubing systems. Look for an updated list of medications that shouldnt be crushed at the institute for safe medication practices web site. You may like list of do not pay insurance 2019 jcaho do not use list 2019 2019 list of do not pay insurance 2018 jcaho do not use list 2016 how do i bill botox injections game for joint commission do not use abbreviation list lsiting of revenue codes that do not require hcpcs codes when do nyc retirees get thier 2016 medicare b reimbursement checks from uft. Ismp canada, accreditation canada, and the canadian patient safety institute will be undertaking joint initiatives to eliminate the use of dangerous abbreviations, symbols and dose designations in health care to enhance the safety of canadian patients. Do not open pradaxa capsules nurses, patients, and others may not be aware that the dabigatran package insert states, the oral bioavailability of dabigatran etexilate pradaxa increases by 75% when the pellets are taken without the capsule shell compared to the intact capsule formulation. However, most psychotropics are available only as tablets or capsules. Ismp s list of errorprone abbreviations, symbols, and dose designations contains abbreviations, symbols, and dose designations which have been reported through the ismp national medication errors reporting program ismp merp as being frequently misinterpreted and involved in harmful medication errors. Medications not to be crushed solely because of poor palatability have been excluded. C this item has been partially implemented for some or all patients, orders, drugs, or staff. Duplicate therapy a t ex do rhn us, algw iv b pm c ent rd ioh pa s fl. If you search do not crush into lexicomp or micromedex they both have a list too. Oral dosage forms that should not be crushed do not. Do not crush list from the institute for safe medication practices ismp home page at double confirmation bias.
Do not crush list institute of safe medication practices. Therefore, when patients have difficulty taking pills, switching to liquid solution or orally disintegrating forms is recommended. The author encourages manufacturers, pharmacists, nurses, and other health professionals to notify him of any changes or updates. Oral dosage forms that should not be crushed february 21, 2020 the list of oral dosage forms that should not be crushed, commonly referred to as the do not crush list, contains medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as oral dosage forms that are sustainedrelease in nature.
B this item has been formally discussed and considered, but it has not been implemented. This will prevent misadministration via the parenteral route. What to consider before giving medications to a patient with a tube or who has trouble swallowing. Ismp list of errorprone abbreviations, symbols, and dose.
Do not crush or chew monthly prescribing reference. Cohen is a member of the nursing2007 editorial advisory board. For more information on ordering policies, procedures, and using a purchase order click the store policies link shown to the left. Oral dosage forms that should not be crushed consumer. Oral dosage forms that should not be crushed disclaimer. List of oral dosage forms that should not be crushed provided by ismp 2018 from. Ismp medication safety tools include workbooks, learning guides, manuals and other materials that cover a variety of medication safety topics. Patients can crush their pills immediately before administration for easier intake. If you tend to do things at the last minute or need your medication from the institute for safe medication practices ismp. Pharmacists and safety personnel can use there free materials to pinpoint specific system weakness in the medicationuse processes and to provide a starting point for successful organizational improvements. Oral dosage forms that should not be crushed institute. Oral dosage forms that should not be crushed empirian health. Oral syringes, preferably labeled in metric ml volume markings only, should be.
Ismp medication safety self assessment for highalert. Wall chart oral dosage forms that should not be crushed. Page 1 of 16 oral dosage forms that should not be crushed john f. If you search do not crush into lexicomp or micromedex they both have. Od every day mistaken for right eye od oculus dexter. Ismp medication safety self assessment for highalert medications. Apr 09, 2019 if you tend to do things at the last minute or need your medication from the institute for safe medication practices ismp. Verifies that daily doses of all prescribed analgesics do not exceed safe maximum doses if administered as frequently as prescribed. Antiretroviral crush do not crush list agents open capsule crush tablet liquid form other formulations notes nucleoside reverse transcriptase inhibitors nrtis abacavir abc ziagen1 yes yes no add to small amount of semisolid food or liquid.
Not sure if its much different from this one but i use those quite a bit. This page consolidates the list of medications which are not to be crushed, but it is not exhaustive. Maybe its a state rule, but we are not supposed to crush meds without a doctors order. The do not crush list from the institute for safe medication practices ismp is referenced by thousands of health care professionals a day.
Typically, though, they will not look at individual medications but rather will just say okay to crush all meds or something like that, so we still have to watch to be sure they arent getting an entericcoated or extendedrelease medication crushed or whatnot. A nurse received an order for a medication without any patients name, which required texting the physician to clarify the order and a delay in enacting the order. Active ingredients dosage forms reasonscomments3 acetaminophen tablet slow. The reason is certain medications have a special release mechanism designed to slowly release a certain amount of medication over a given extended time.
January 2014 drug product active ingredients2 dosage forms reasonscomments3 aciphex rabeprazole tablet extended. An updated list of frequently asked questions about this jcaho. Institute for safe medication practices ismps list of. For example, the ismp do not crush list can be entered into the system so that warning stickers can be printed at the point of dispensing, to be stuck on the pill bottle. This listing is not meant to represent all products generic name. Do not crush or chew6 aripiprazole sandoz swallow whole3 anastrazole rolin tablet film coated3 do not halve3 ascorbic acid cvite tablet no information aspirin ec crush, chew or disperse ethics aspirin ec tablet enteric coated, swallow whole. Oral dosage forms that should not be crushed korman healthcare wpcontentuploads202003donotcrushmedications. I was wondering if anyone had access and could link me a pdf or word file for the ismp do not crush list for either 2018 or 2019.
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