Enteral feeding tubes (EFTs) are often the only way for a patient with swallowing difficulties to receive prescribed therapy. The purpose of this master's thesis was to identify potential drug interactions (PIs) using the online Lexi-comp® program, and in the Summary of Product Characteristics (SmPC) and in the literature source to verify the adequacy of therapy in terms of crushing solid dosage forms (DF) for administration via EFT in patients admitted to the Clinic for Otorhinolaryngology and Cervicofacial Surgery (ORL) in 2020. In addition, the understanding of the correct preparation and administration of drugs via EFT was evaluated using a specially developed questionnaire for medical staff at the ORL. Clinically significant interactions (types D and X) were observed in 58 patients who were able to swallow (per os) and in 122 patients with inserted EFT. In both groups of patients, a total of 284 D-type interactions and 131 X-type interactions occurred. Combinations with non-steroidal anti-inflammatory drugs (NSAIDs) were most commonly identified in both types of interactions. In D-type interactions, these were NSAID interactions with aspirin, escitalopram, and furosemide, also common were interactions of NSAID with agents which affect the central nervous system such as clomethiazole, nitrazepam, tramadol, and scopolamine. In X-type interactions, the most common interaction was between ibuprofen and metamizole (61.1 % of all X- type interactions). Patients with inserted EFT were inspected if their therapy (167 different solid DFs) had been appropriate in terms of crushing drugs for dissolution and administration via EFT. According to the SmPC, crushing tablets or opening capsules is allowed for 10 drugs (6.0 %), forbidden or not recommended for 44 drugs (26.3 %), and not listed for the rest (67.6 %). According to the literature source, crushing tablets or opening capsules is allowed for 37 drugs (22.2 %) and not allowed for 20 drugs (12.0 %). Following the example of the French research, we distributed 38 questionnaires among the medical staff at the ORL, with which we checked how the application of drugs via EFT takes place in practice. We received 31 filled out questionnaires (81.6 %). Employees mostly know that coated tablets should not be crushed, and they are also aware of the proper way of dissolving them in different solutions. However, their knowledge of administration of drugs together with food is problematic, and certain hygiene standards are also questionable. In the future, the application of drugs to patients with difficulty swallowing can be improved by developing more detailed instructions for crushing drugs, by avoiding the use of combinations of drugs that are involved in clinically important interactions, and by including a (clinical) pharmacist in the medical team.
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