Question

A quality assurance assessment of patients receiving phenytoin suspension and enteral feedings via a nasogastric tube demonstrates consistently sub-therapeutic phenytoin levels. Phenytoin suspension is dosed twice a day. What should the pharmacist do to improve administration of phenytoin?

Answer 1

To improve administration of phenytoin suspension in patients receiving enteral feedings via a nasogastric tube, the pharmacist should consider timing, tube placement, and alternative formulations.

Step-by-step explanation:

To improve the administration of phenytoin suspension in patients receiving enteral feedings via a nasogastric tube, the pharmacist should consider several factors:

1. Timing: Phenytoin suspension should be administered at least 2 hours before or after enteral feedings to avoid any potential interactions that may reduce its absorption.
2. Tube placement: Verify that the nasogastric tube is properly placed in the stomach to ensure the medication is delivered to the intended site.
3. Formulation: Explore alternative formulations of phenytoin, such as a different dosage form (e.g., extended-release tablets) or a different route of administration, that might be better suited for patients receiving enteral feedings.

By addressing these considerations, the pharmacist can optimize the administration of phenytoin suspension in patients using nasogastric tubes during enteral feedings.