Comparison of Dosage Loss Between Medications Crushed with Two Different Methods by Two Nurses: An In Vitro Study

Abstract

Objective: Administration of crushed medications can lead to various problems associated with use of inappropriate crushing method, such as administration of an incorrect dosage, alterations in drug bioavailability, and reduction in the effectiveness of the treatment. This experimental study aimed to compare the dosage loss of crushed metoclopramide hydrochloride (MT-HCI) 10-mg tablet using two crushing methods.

Methods: MT-HCI 10 mg tablets (n=80) were crushed by two nurses, and each nurse used a pill crusher and a pestle and plastic bag to crush the tablet. Dosage loss was calculated by a specialist pharmacist in a laboratory environment.

Results: The dosage loss was 0.515 +/- 0.299 mg (5.16%) with the pestle and self-sealing plastic bag and 0.415 +/- 0.359 mg (4.16%) with the pill crusher. No statistically significant difference was found between the two methods (p>0.05). The mean dosage loss was 0.482 +/- 0.367 mg for the first nurse and 0.449 +/- 0.298 mg for the second nurse. No statistically significant difference was noted in the mean dose between the two nurses (p>0.05).

Conclusion: This study found no significant difference between the nurses and die crushing methods, but the mean dosage loss with both methods was not within the limits recommended by the United States Food and Drug Administration.