An estimated 3.75 billion drug administrations were made to patients in United States hospitals in 1998, of which approximately 10% received their medications through an enteral tube as liquids. This number is growing. Despite the availability of a vast drug pharmacopoeia and sophisticated medication distribution system, institutional care givers still liquify capsules and tablets at the bedside for over 55% of the liquid medication needs of their patients. This """"""""extemporaneous compounding of liquid medications"""""""" [ECLM] from solid drug forms has significant problems impacting caregiver efficiency, enteral tube failure, and safe and effective administration of [liquid] medications; problems unremedied by pharmaceutical manufacturers, pharmacy intervention, or legacy drug crushing devices. In preliminary studies, we have demonstrated that ultrasound can rapidly and successfully liquify all types of medications appropriate for liquid enteral administration, while avoiding many shortcomings of legacy methods. The approach has considerable potential to decrease costs and improve medication use in acute and long term institutional care settings. In the Phase I effort we propose to build a proof of concept ultrasonic device optimized to liquify solid medications, and examine the processing variables to maximize efficiency and drug stability. The Phase II study would complete the processing variable study, consider methods of direct administration, include comprehensive drug compatibility testing, and incorporate device user requirements.
An innovative ultrasonic desktop device and process to rapidly and automatically liquefy solid drug dosage forms at the point of use will be a commercially viable product with medical and economic benefits. The device will provide a significant improvement in the delivery of nursing care to a large, specialized patient population. The improved medication delivery process will benefit nursing practice, improved medication related outcomes, decrease incidental hospitalization costs, and provide a platform from which best practice can be defined.
