Medication Administration Through Nasogastric (NG) Tubes

Proper Medication Administration via NG Tube

Crushing medications for NG tube administration should be avoided whenever possible due to potential risks of drug exposure and inaccurate dosing, with liquid formulations preferred when available 1, 2
Consult with a pharmacist before administering any medication through an NG tube to confirm appropriateness and proper administration technique 3, 4
The necessity and appropriateness for drug administration through an enteral tube should be confirmed, considering the site of drug delivery and potential interactions with enteral formula 1

Use appropriate ancillaries including syringes with connectors of a recognized standard (ISO 80369-3/"ENFit") to avoid misconnection errors 5, 6
Flush the tube with at least 30 mL of water before and after medication administration to prevent tube obstruction 7, 8
For continuous feeding, flush tubes every 4 hours if medications are being administered 9

Be cautious with liquid medications containing high osmolality (>500-600 mOsm/kg) as they can cause gut disturbances 2
Crushing tablets or opening capsules should be avoided whenever possible 1, 2
Higher incidence of tube occlusions when using crushed solid dosage forms through nasogastric tubes 1

Patient and caregiver education regarding proper medication administration through enteral tubes is essential but often lacking 5
Using products outside the terms of their Summary of Product Characteristics carries additional responsibility that should be accepted prior to medicine prescription, supply or administration 2
When using low-dose ENFit syringes, do not shake the syringe to remove drug moat as this exposes people to the drug and affects dose delivered 6