Article Text
Abstract
Background and Importance Swallowing problems are common in paediatric patients, elderly patients and some pathologies. A common nursing practice is the administration of enteral nutrition (EN) formulas together with drugs through feeding tubes. In recent years, the number of tyrosine kinase inhibitor (TKI) drugs for the treatment of oncohaematological pathologies has grown enormously.
Aim and Objectives To identify alternatives to oral administration of TKIs in patients with swallowing problems.
Material and Methods A literature review was performed in August 2023 on the conditions for handling and administration of the TKIs used in our hospital in patients with swallowing problems. The respective technical data sheets and clinical practice guidelines were reviewed, as well as specific articles.
Variables possibility of administration by feeding tubes, manipulative technique of the dosage form, dissolution medium, need to prepare a magistral formula in the Pharmacy Service, special administration conditions and compatibility with EN.
Results 31 TKI drugs were identified in our hospital. Of these, information was available for 24.
Of the drugs with information (possibility of administration by feeding tubes: 22; alternative dosage form exists: 1; no alternative exists: 1). By manipulative technique (crush and dissolve: 15; disperse without crushing: 7), dissolution medium (10–20ml of water: 6; >20ml of water: 5; acid and >20ml: 2; >40°C and 10–20ml of water: 3; >40°C and >20ml: 1; others: 5). 4 drugs require the preparation of a magistral formula in the Pharmacy Service. Special administration conditions (photoprotection: 3; 1: >8Fr feeding tubes: 1). 14 ITKs are compatible with EN; in the remaining cases, separate administration is recommended (1 hour before or 2 hours later).
Conclusion and Relevance Despite numerous sources of information, there is a 20% of TKI without evidence. Furthermore, compatibility with EN administration is based on analogy with oral forms of administration.
References and/or Acknowledgements No conflict of interest.
Conflict of Interest No conflict of interest.