Please share if you have a policy clarifying medications administered via a feeding tube (specifically jejunostomy tube).
We experienced an issue with medication delivery via a feeding jejunostomy tube (J tube). The tube became clogged twice with the second clog unable to be salvaged. Although jejunostomy tubes can on rare occasions be used to deliver medications, general practice is to completely avoid doing so, if at all possible, especially if another viable route exists.
Medications per J tube can lead to several problems:
1. inadequate dosing of said medications
2. malabsorption of said medications due to bypassing of normal site of intestinal metabolism
3. precipitation of proteins and other compounds when mixed with enteral formulas
4. tube clogging and malfunction
5. frequent interruption of necessary nutritional support
6. caustic ulceration and damage to small bowel mucosa, including potential necrosis and perforation in rare cases
Our surgeon is requesting a policy be created in an attempt to better clarify nursing/pharmacy protocols regarding medication delivery via enteral feedings.