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Archive for the ‘split tablets’ Category

Researchers from the Faculty Pharmacy, University of Ghent, Belgium, found that nearly 31% of the tablets which are divided into fragments move away from their target weight 15% or more. Another 14% of fragmented tablets differ from the recommended dose in 25% or more, according to the study, published in the Journal of Advanced Nursing.

The paper points out that the practice could have serious clinical consequences for the pills, which have a narrow margin between therapeutic and toxic doses.

For the study, five volunteers divided eight pills of various sizes using three tools: a kitchen knife, scissors and a special device to split tablets. Even the most accurate method (appliance division) caused an error margin of 15 to 25% in 13% of cases. Each fragment was weighed after the partition to determine how much is diverted from the target weight.

Dr. Charlotte Verge, research coordinator, said he decided to conduct the study after nursing home nurses asked him what was the best method to split the pills in daily practice, regardless of type or size, or whether there were lines of separation.

The group of five volunteers, only one (lab technician) had experience in the division of pills, Verge said, and believes that this situation is common in nursing homes where there is always a registered nurse performs this task.

Participants divided eight pills of different shapes and sizes, prescribed for conditions such as Parkinson’s disease, congestive heart failure and arthritis in 3,600 halves or quarters. Three pills were no dividing lines; three had a separation line and the other two.

“Nurses are the ones that should split the pills, but not always the case in daily practice” because of staff shortages, said Verge. “Also, I do not think that nurses have special training in the division of tablets,” he added.

The division of tablets and pills is a daily practice in nursing homes. However, according to the authors of the work, not all formulations are suitable for separation, and even when they are large deviations may occur in the dose or target weight loss. This could have serious clinical consequences of drugs where there is little difference between therapeutic and toxic doses. Verge notes that even tiny deviations in the dose of some drugs can cause critical problems, such as remedies for irregular heart rhythm, blood clots and seizures.