Logrippo Serena, Ricci Giovanna, Sestili Matteo, Cespi Marco, Ferrara Letizia, Palmieri Giovanni F, Ganzetti Roberta, Bonacucina Giulia, Blasi Paolo
School of Advanced Studies; School of Pharmacy.
School of Law, University of Camerino, Camerino.
Clin Interv Aging. 2017 Jan 31;12:241-251. doi: 10.2147/CIA.S121905. eCollection 2017.
Demographic indicators forecast that by 2050, the elderly will account for about one-third of the global population. Geriatric patients require a large number of medicines, and in most cases, these products are administered as solid oral solid dosage forms, as they are by far the most common formulations on the market. However, this population tends to suffer difficulties with swallowing. Caregivers in hospital geriatric units routinely compound in solid oral dosage forms for dysphagic patients by crushing the tablets or opening the capsules to facilitate administration. The manipulation of a tablet or a capsule, if not clearly indicated in the product labeling, is an off-label use of the medicine, and must be supported by documented scientific evidence and requires the patient's informed consent. Compounding of marketed products has been recognized as being responsible for an increased number of adverse events and medical errors. Since extemporaneous compounding is the rule and not the exception in geriatrics departments, the seriousness and scope of issues caused by this daily practice are probably underestimated. In this article, the potential problems associated with the manipulation of authorized solid oral dosage forms are discussed.
人口统计指标预测，到2050年，老年人将占全球人口的三分之一左右。老年患者需要大量药物，在大多数情况下，这些产品以固体口服剂型给药，因为它们是目前市场上最常见的剂型。然而，这一人群往往存在吞咽困难。医院老年病房的护理人员通常会通过碾碎片剂或打开胶囊来为吞咽困难的患者调配固体口服剂型，以便于给药。如果产品标签中未明确说明，对片剂或胶囊进行的这种操作属于药物的超说明书使用，必须有书面科学证据支持，并且需要患者的知情同意。市售产品的调配已被认为是不良事件和医疗差错增加的原因。由于临时调配在老年病科是惯例而非例外，这种日常做法所导致问题的严重性和范围可能被低估了。本文讨论了与授权固体口服剂型操作相关的潜在问题。
