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

PloS One
Min Yew ThongKathryn J Steadman

Abstract

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 recove...Continue Reading

References

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Citations

Feb 23, 2019·Journal of Clinical Pharmacy and Therapeutics·Nicole McDerbyMark Naunton
Nov 6, 2018·Current Clinical Pharmacology·Georgios Papazisis, Spyridon Siafis
Apr 25, 2020·International Journal of Clinical Pharmacy·Aida Sefidani ForoughLisa M Nissen
Jan 21, 2021·Patient Preference and Adherence·Chandramouli RadhakrishnanKathryn J Steadman
Feb 10, 2021·Geriatric Nursing·Hege SolbergRose Mari Olsen

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Methods Mentioned

BETA
scraping

Software Mentioned

GraphPad
GraphPad Prism

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