Avoid crushing pills before taking them
The thought of swallowing pills makes me nauseated especially when I am dealing with bitter tablets such as chloroquine or quinine.
By Esther Alalo
The thought of swallowing pills makes me nauseated especially when I am dealing with bitter tablets such as chloroquine or quinine. As a child, I was beaten on several occasions for throwing away tablets. My parents resorted to crushing them thinking it made it easier. I have seen many women doing this and some add sugar or sweet drinks to make swallowing easy. But this may not be a good idea.
Experts have warned that crushing drugs could cause serious side effects that can sometimes be fatal.
A group of US pharmacists and lawyers carried out a study and came out with a list of reasons why crushing tablets should be discouraged.
They discovered that over 60% of older people have trouble swallowing medication and 80% of nurses in care homes resort to crushing tablets to help residents take medicines.
They say pills often have a special coating that affects the way they are released into the body.
“Special coatings can mean a drug is absorbed over a long period of time, so a patient only has to take a tablet once a day, rather than several times a day,†they said.
Crushing them can mean this complex system is disturbed.
David Wright, a senior lecturer in pharmacy at the University of East Anglia, explained that crushing the pills increases the risk of a patient getting a large dose of the drug which should be released slowly, or a drug being cleared from the body too early before it can do anything.
The experts said there are drugs which should not be crushed such as the breast cancer drugs, tamoxifen and morphine.
“Crashing tamoxifen could result in the person who is breaking up the tablet breathing in the medication which can be particularly dangerous if they are pregnant. Crushing morphine could lead to a fatally fast release of the drug,†said Wright.
They also warned that Nifedipine, the angina and blood pressure drug causes dizziness, headaches and increases risks of stroke or heart attack when crushed.
Dr Florence Nakachwa, a pharmacist at the National Drug Authority, said the biggest problem we have in Uganda is about the dosage.
“One may end up not taking a full dose as required, because some particles remain on the spoon or fall out during the process of crushing,†she said.
She adds that tablets that may require breaking into halves before swallowing, may not be measured accurately thus under-dosing or over-dosing the patients, especially children.
Nakacwa agrees that while fatalities can happen, they are not common.
Instead of crushing the tablet for patients with difficulties in swallowing drugs, Nakachwa advises that an alternative be sought.
“A patient can be given an oral alternative. Bitter drugs now come with sugar coatings or syrup alternatives,†she said.
Both Dr. Wright and Nakacwa strongly advise patients to always inform doctors if they have problems swallowing drugs.
Ends
The thought of swallowing pills makes me nauseated especially when I am dealing with bitter tablets such as chloroquine or quinine. As a child, I was beaten on several occasions for throwing away tablets. My parents resorted to crushing them thinking it made it easier. I have seen many women doing this and some add sugar or sweet drinks to make swallowing easy. But this may not be a good idea.
Experts have warned that crushing drugs could cause serious side effects that can sometimes be fatal.
A group of US pharmacists and lawyers carried out a study and came out with a list of reasons why crushing tablets should be discouraged.
They discovered that over 60% of older people have trouble swallowing medication and 80% of nurses in care homes resort to crushing tablets to help residents take medicines.
They say pills often have a special coating that affects the way they are released into the body.
“Special coatings can mean a drug is absorbed over a long period of time, so a patient only has to take a tablet once a day, rather than several times a day,†they said.
Crushing them can mean this complex system is disturbed.
David Wright, a senior lecturer in pharmacy at the University of East Anglia, explained that crushing the pills increases the risk of a patient getting a large dose of the drug which should be released slowly, or a drug being cleared from the body too early before it can do anything.
The experts said there are drugs which should not be crushed such as the breast cancer drugs, tamoxifen and morphine.
“Crashing tamoxifen could result in the person who is breaking up the tablet breathing in the medication which can be particularly dangerous if they are pregnant. Crushing morphine could lead to a fatally fast release of the drug,†said Wright.
They also warned that Nifedipine, the angina and blood pressure drug causes dizziness, headaches and increases risks of stroke or heart attack when crushed.
Dr Florence Nakachwa, a pharmacist at the National Drug Authority, said the biggest problem we have in Uganda is about the dosage.
“One may end up not taking a full dose as required, because some particles remain on the spoon or fall out during the process of crushing,†she said.
She adds that tablets that may require breaking into halves before swallowing, may not be measured accurately thus under-dosing or over-dosing the patients, especially children.
Nakacwa agrees that while fatalities can happen, they are not common.
Instead of crushing the tablet for patients with difficulties in swallowing drugs, Nakachwa advises that an alternative be sought.
“A patient can be given an oral alternative. Bitter drugs now come with sugar coatings or syrup alternatives,†she said.
Both Dr. Wright and Nakacwa strongly advise patients to always inform doctors if they have problems swallowing drugs.
Ends