Oral liquids enteral feeding

Oral liquid medicines may be a good choice of dosage form for patients who have problems with swallowing tablets and capsules, or if they have an enteral feeding tube, or for whom the required dose does not fit with the available tablet(s) or capsule(s) such as is often the case with children and elderly people. A liquid dosage form is easy to measure and administer. 

In nursing homes psychoactive medicines are commonly administered as drops. If there is no oral liquid form available, the pharmacist may receive a doctor s prescription for the adaptation of an oral solid into an oral liquid. Tablets may be pulverised or capsules can be emptied and administered with semisolid food. However, there may be other solutions such as improving swallowing technique or a different administration route. Even for patients with an enteral feeding tube there may be alternatives or at least points of attention. 

The viscosity of the oral liquid has to be low enough to be administered through an enteral feeding tube. If necessary they have to be diluted with water. However, some solutions may precipitate upon dilution, e.g. because they contain co-solvents. Dilution also causes a decrease of the solubility of the active substance. Therefore solutions with co-solvents have to be administered undiluted. 

Enteral nutrition (EN) is broadly defined as delivery of nutrients via the gastrointestinal (GI) tract. This could include normal oral feeding as well as delivery of nutrients in a liquid form by a tube. Sometimes when the term enteral nutrition is used, only tube feedings are included hence the terms enteral nutrition and tube feedings are often used synonymously. The bulk of this chapter will include information regarding delivery of feedings via tubes. Formulas for EN usually are delivered in the form of commercially prepared liquid preparations, although some products are produced as powders for reconstitution. 

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