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Drug loss while crushing tablets: Comparison of 24 tablet crushing devices

This study investigated 24 tablet crushing devices for drug loss using different methods to recover the crushed tablet. 24 devices were compared: 3 with disposable cups, 6 with disposable bags, 12 without separate vessels and 3 types of mortar and pestle. One paracetamol tablet was crushed and recov...

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Detalles Bibliográficos
Autores principales: Thong, Min Yew, Manrique, Yady J., Steadman, Kathryn J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832315/
https://www.ncbi.nlm.nih.gov/pubmed/29494695
http://dx.doi.org/10.1371/journal.pone.0193683
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author Thong, Min Yew
Manrique, Yady J.
Steadman, Kathryn J.
author_facet Thong, Min Yew
Manrique, Yady J.
Steadman, Kathryn J.
author_sort Thong, Min Yew
collection PubMed
description This study investigated 24 tablet crushing devices for drug loss using different methods to recover the crushed tablet. 24 devices were compared: 3 with disposable cups, 6 with disposable bags, 12 without separate vessels and 3 types of mortar and pestle. One paracetamol tablet was crushed and recovered by tapping the powder out. Where appropriate, depending on crusher size and manufacturer instructions, the powder was also recovered by mixing with water or food. Paracetamol recovery (quantity that can be delivered to a patient) and leftover (quantity remaining in the device) were measured using a validated UV method and the entire experiment was replicated 3 times. Drug recovery ranged from 86.7–98.1% when the crushed tablet was tapped out of the crushers (average loss 5.8%). Significant losses were measured for 18 crushers, particularly manually operated hand-twist crushers with a serrated crushing surface, and some devices with disposable bags or cups. Rinsing the crushed powder with water once resulted in an average of 24.2% drug loss, and this was reduced to 4.2% after a second rinse. If crushing is unavoidable, maximizing medication delivery to the patient is essential. Rinsing twice resulted in similar paracetamol recovery to tapping the powder out; however only water rinses have the potential for direct consumption by the patient, minimizing drug loss across the entire crushing and transfer process.
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spelling pubmed-58323152018-03-23 Drug loss while crushing tablets: Comparison of 24 tablet crushing devices Thong, Min Yew Manrique, Yady J. Steadman, Kathryn J. PLoS One Research Article This study investigated 24 tablet crushing devices for drug loss using different methods to recover the crushed tablet. 24 devices were compared: 3 with disposable cups, 6 with disposable bags, 12 without separate vessels and 3 types of mortar and pestle. One paracetamol tablet was crushed and recovered by tapping the powder out. Where appropriate, depending on crusher size and manufacturer instructions, the powder was also recovered by mixing with water or food. Paracetamol recovery (quantity that can be delivered to a patient) and leftover (quantity remaining in the device) were measured using a validated UV method and the entire experiment was replicated 3 times. Drug recovery ranged from 86.7–98.1% when the crushed tablet was tapped out of the crushers (average loss 5.8%). Significant losses were measured for 18 crushers, particularly manually operated hand-twist crushers with a serrated crushing surface, and some devices with disposable bags or cups. Rinsing the crushed powder with water once resulted in an average of 24.2% drug loss, and this was reduced to 4.2% after a second rinse. If crushing is unavoidable, maximizing medication delivery to the patient is essential. Rinsing twice resulted in similar paracetamol recovery to tapping the powder out; however only water rinses have the potential for direct consumption by the patient, minimizing drug loss across the entire crushing and transfer process. Public Library of Science 2018-03-01 /pmc/articles/PMC5832315/ /pubmed/29494695 http://dx.doi.org/10.1371/journal.pone.0193683 Text en © 2018 Thong et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Thong, Min Yew
Manrique, Yady J.
Steadman, Kathryn J.
Drug loss while crushing tablets: Comparison of 24 tablet crushing devices
title Drug loss while crushing tablets: Comparison of 24 tablet crushing devices
title_full Drug loss while crushing tablets: Comparison of 24 tablet crushing devices
title_fullStr Drug loss while crushing tablets: Comparison of 24 tablet crushing devices
title_full_unstemmed Drug loss while crushing tablets: Comparison of 24 tablet crushing devices
title_short Drug loss while crushing tablets: Comparison of 24 tablet crushing devices
title_sort drug loss while crushing tablets: comparison of 24 tablet crushing devices
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832315/
https://www.ncbi.nlm.nih.gov/pubmed/29494695
http://dx.doi.org/10.1371/journal.pone.0193683
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