ALS From Both Sides, Care of an ALS Patient By Diane Huberty, Retired RN, Certified Neuro Nurse and ALS Patient

Feeding Tubes and Pills

Putting medications through the feeding tube is generally not a problem, but there are rules to be followed.

Most pills can be crushed, put in water, and poured down the tube. They have to be well crushed so investing in some sort of pill crusher is helpful. A simple mortar and pestle (bowl with a rounded club) works well. It is hard to find as a medical product—look for it as a cooking tool. There are many other types of crushers available but if your caregiver has arthritis, you may have to try a couple of before you find a usable one.

Many medications are available in liquid form—for a price! Simple Tylenol tablets all seem to be coated these days, but still can be crushed with a bit of extra grinding. If you want liquid Tylenol, children's liquid is readily available. It is more concentrated than adult liquid, so make certain you aren't using too much. Adult vitamins are about three times more expensive in liquid form even if available but are increasingly common in chewable form that can be easily crushed.

The problem medications are those that are designed to release slowly into the digestive tract for longer, more even effect. If crushed the entire dose will hit all at once and that is not at all good. These medicines usually have sustained-release [SR], extended-release [ER, XR, XL], controlled-release [CR], after their name. Often they are capsules with beads of medication inside. If a tablet has a line scored across it for cutting, it can be crushed as can meds labeled as immediate-release (IR) Try to remember to let your doctor know that you need crushable or liquid medication and double check with the pharmacist. See the list of "Do Not Crush" medications at Do Not Crush List

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