In context of enteral tube medication administration, which statement is true?

• A. Liquid formulations are always preferred to solid forms
• B. Crushing modified-release forms is acceptable if followed by a water flush
• C. Enteric-coated or film-coated tablets should not be crushed due to clumping risk
• D. Flushing the tube is optional

Answer: (C)

When giving medicines through an enteral tube, how a tablet is formulated matters for both safety and effectiveness. Enteric-coated and film-coated tablets have special coatings or design features that control where and how the drug is released or protect the stomach and taste. Crushing these coatings defeats that purpose. If an enteric-coated tablet is crushed, the drug may release in the stomach instead of the intended site, which can irritate the stomach, alter absorption, or change the amount that gets into the bloodstream. For film-coated tablets, removing the coating can remove protection from stomach acid or mask taste, and it can also lead to unpredictable absorption. Plus, powders from crushed tablets can clump inside the tube and clog it, blocking delivery of the medication. That’s why the best practice is to avoid crushing enteric-coated or film-coated tablets and seek alternatives like a liquid formulation or a different product as advised by a pharmacist.

For context, other statements are not reliable. Liquid forms aren’t always the preferred option—availability, stability, and dosing considerations vary by drug. Crushing medications that are designed to release over time (modified-release) changes their release profile and can be dangerous. Flushing the tube is not optional; adequate flushing before and after administration helps prevent occlusion and ensures the full dose is delivered.