Using an acidic fluid is key. with PACER. I've never tried coca-cola as a declogger though. Great hint Karen. I know you have tons of experience with this. I have given the PACER first and used the other meds as a 'G-tube flush' before the final one. These questions and the information shared is so helpful for the practical side of nurse case management. Thanks

Denise
From: ntca.simplelists.com listserve [nobody@simplelists.com]
Sent: Saturday, February 17, 2018 7:17 PM
To: tbnurses@ntca.simplelists.com
Subject: Daily digest for tbnurses@ntca.simplelists.com

(Previous discussion continued)
Re: Daily digest for tbnurses@ntca.simplelists.com - Farrell, Karen L (16 Feb 2018 19:57 EST)
RE: Daily digest for tbnurses@ntca.simplelists.com - Raftery, Ann (16 Feb 2018 20:35 EST)
RE: Daily digest for tbnurses@ntca.simplelists.com - Raftery, Ann (16 Feb 2018 21:10 EST)
Re: Daily digest for tbnurses@ntca.simplelists.com by Farrell, Karen L (16 Feb 2018 19:57 EST)
Reply to list

    PAS are enteric coated granules. It should be and I would recommend dissolving in an acidic fluid or given in an acidic food. The granules should not be crushed.  They can definitely cause GI distress and intolerance.   You definitely want to flush the G-tube with tap water (90 ml's) before and after administering the medication. Clamping the tube should occur for a half hour. If the tube becomes clogged, Coca Cola is your friend!  It is a great declogger!!  Hope this is helpful. Thanks Karen 

    Sent from my iPhone
    Karen Farrell RN BSN RM
    Executive Community Nursing Services Director
    Bureau of Communicable Diseases, TB Control Section, Florida Department of Health
    345 South Congress Avenue
    Annex Bldg., Room 231-232
    Delray Beach, FL  33445
    Office:  561-266-6634
    Fax:  561-266-6633
    Cell:  561-662-5642

    On Feb 16, 2018, at 7:21 PM, ntca.simplelists.com listserve <nobody@simplelists.com> wrote:
    (Previous discussion continued) RE: Daily digest for tbnurses@ntca.simplelists.com - Teresa Nowland (16 Feb 2018 10:11 EST) RE: Daily digest for tbnurses@ntca.simplelists.com by Teresa Nowland (16 Feb 2018 10:11 EST)
    Reply to list

    When I had this type of patient we gave the finely crushed medications through the tube with flushing before and after.

    Being you are lucky enough that the patient is able to take the medication orally than yes keep the tube clamped.

     

    Teresa

     

    Nurse Case Manager

    815 N. Broadway Ave. Suite 155

    Tyler, TX 75702

    Phone: 903-510-5608

    Cell: 903-258-7502

    Fax: 903-535-0759

    tnowland@netphd.org

    www.healthyeasttx.com

     

     

    From: ntca.simplelists.com listserve [mailto:nobody@simplelists.com]
    Sent: Thursday, February 15, 2018 6:28 PM
    To: tbnurses@ntca.simplelists.com
    Subject: Daily digest for tbnurses@ntca.simplelists.com

     

    Administering PAS via G tube - Sabuwala, Nadya (MDH) (15 Feb 2018 18:13 EST)

    Administering PAS via G tube by Sabuwala, Nadya (MDH) (15 Feb 2018 18:13 EST)
    Reply to list

    Hello fellow nurse,

    1.      Are any of you familiar with or have any tips or resources regrading administering Pacer via a G tube?

    2.      Do you clamp the tube for a while after administering all TB medications through a G tube? If yes, for how long do you clamp the tube?

     

    Thanks for your help,

    Nadya

     

     

    Nadya Sabuwala PHN, RN, MSN, MPH

    Nurse Consultant
    Minnesota Department of Health
    Infectious Disease Epidemiology, Prevention and Control
    625 Robert Street N| P.O. Box 64975
    St. Paul, MN  55164-0975
    p (651) 201-5548 |  f (651) 201-5500

     

    To reply to a posting, simply reply. To start a new thread, address it to tbnurses@ntca.simplelists.com and put in a concise subject line. You are on the daily digest setting for the listserve.The archives for this list are at http://ntca.simplelists.com/tbnurses. If you have problems with the listserve, please contact Lorna Will at lwill@tbcontrollers.org
    To reply to a posting, simply reply. To start a new thread, address it to tbnurses@ntca.simplelists.com and put in a concise subject line. You are on the daily digest setting for the listserve.The archives for this list are at http://ntca.simplelists.com/tbnurses. If you have problems with the listserve, please contact Lorna Will at lwill@tbcontrollers.org
RE: Daily digest for tbnurses@ntca.simplelists.com by Raftery, Ann (16 Feb 2018 20:35 EST)
Reply to list

    Hello Nadya,

    That’s a great question!  I think if you are restricted to administering the meds via G tube, you may wish to discuss with the treating MD whether there is an alternative to PAS as PASER granules shouldn’t be crushed and whole granules could clog the G tube.  You can confirm this with your Pharmacist.  There is a parenteral preparation I’ve seen used internationally but it is not available in the U.S. to my knowledge.  I would think your best bet would be to see if there is an alternative drug to replace the PAS if the patient is unable to swallow the granules.

    Please share with us if you find a work around for your patient.  These are situations I think we all can learn from!

    Kind regards,

    Ann

     

    Ann Raftery, RN, PHN, MS

    Curry International Tuberculosis Center

    University of California, San Francisco

     

     

    From: ntca.simplelists.com listserve [mailto:nobody@simplelists.com]
    Sent: Friday, February 16, 2018 4:21 PM
    To: tbnurses@ntca.simplelists.com
    Subject: Daily digest for tbnurses@ntca.simplelists.com

     

    (Previous discussion continued)

    RE: Daily digest for tbnurses@ntca.simplelists.com - Teresa Nowland (16 Feb 2018 10:11 EST)

    RE: Daily digest for tbnurses@ntca.simplelists.com by Teresa Nowland (16 Feb 2018 10:11 EST)
    Reply to list

    When I had this type of patient we gave the finely crushed medications through the tube with flushing before and after.

    Being you are lucky enough that the patient is able to take the medication orally than yes keep the tube clamped.

     

    Teresa

     

    Nurse Case Manager

    815 N. Broadway Ave. Suite 155

    Tyler, TX 75702

    Phone: 903-510-5608

    Cell: 903-258-7502

    Fax: 903-535-0759

    tnowland@netphd.org

    www.healthyeasttx.com

     

     

    From: ntca.simplelists.com listserve [mailto:nobody@simplelists.com]
    Sent: Thursday, February 15, 2018 6:28 PM
    To: tbnurses@ntca.simplelists.com
    Subject: Daily digest for tbnurses@ntca.simplelists.com

     

    Administering PAS via G tube - Sabuwala, Nadya (MDH) (15 Feb 2018 18:13 EST)

    Administering PAS via G tube by Sabuwala, Nadya (MDH) (15 Feb 2018 18:13 EST)
    Reply to list

    Hello fellow nurse,

    1.      Are any of you familiar with or have any tips or resources regrading administering Pacer via a G tube?

    2.      Do you clamp the tube for a while after administering all TB medications through a G tube? If yes, for how long do you clamp the tube?

     

    Thanks for your help,

    Nadya

     

     

    Nadya Sabuwala PHN, RN, MSN, MPH

    Nurse Consultant
    Minnesota Department of Health
    Infectious Disease Epidemiology, Prevention and Control
    625 Robert Street N| P.O. Box 64975
    St. Paul, MN  55164-0975
    p (651) 201-5548 |  f (651) 201-5500

     

    To reply to a posting, simply reply. To start a new thread, address it to tbnurses@ntca.simplelists.com and put in a concise subject line. You are on the daily digest setting for the listserve.The archives for this list are at http://ntca.simplelists.com/tbnurses. If you have problems with the listserve, please contact Lorna Will at lwill@tbcontrollers.org

    To reply to a posting, simply reply. To start a new thread, address it to tbnurses@ntca.simplelists.com and put in a concise subject line. You are on the daily digest setting for the listserve.The archives for this list are at http://ntca.simplelists.com/tbnurses. If you have problems with the listserve, please contact Lorna Will at lwill@tbcontrollers.org
RE: Daily digest for tbnurses@ntca.simplelists.com by Raftery, Ann (16 Feb 2018 21:10 EST)
Reply to list

    Also meant to add that you might pose your question also to your TB Center of Excellence consultation line as I’m sure they would have some specific suggestions that would be helpful in this situation.

    Ann

     

    Ann Raftery, RN, PHN, MS

    Curry International Tuberculosis Center

    University of California, San Francisco

     

     

    From: Raftery, Ann
    Sent: Friday, February 16, 2018 5:35 PM
    To: tbnurses@ntca.simplelists.com
    Subject: RE: Daily digest for tbnurses@ntca.simplelists.com

     

    Hello Nadya,

    That’s a great question!  I think if you are restricted to administering the meds via G tube, you may wish to discuss with the treating MD whether there is an alternative to PAS as PASER granules shouldn’t be crushed and whole granules could clog the G tube.  You can confirm this with your Pharmacist.  There is a parenteral preparation I’ve seen used internationally but it is not available in the U.S. to my knowledge.  I would think your best bet would be to see if there is an alternative drug to replace the PAS if the patient is unable to swallow the granules.

    Please share with us if you find a work around for your patient.  These are situations I think we all can learn from!

    Kind regards,

    Ann

     

    Ann Raftery, RN, PHN, MS

    Curry International Tuberculosis Center

    University of California, San Francisco

     

     

    From: ntca.simplelists.com listserve [mailto:nobody@simplelists.com]
    Sent: Friday, February 16, 2018 4:21 PM
    To: tbnurses@ntca.simplelists.com
    Subject: Daily digest for tbnurses@ntca.simplelists.com

     

    (Previous discussion continued)

    RE: Daily digest for tbnurses@ntca.simplelists.com - Teresa Nowland (16 Feb 2018 10:11 EST)

    RE: Daily digest for tbnurses@ntca.simplelists.com by Teresa Nowland (16 Feb 2018 10:11 EST)
    Reply to list

    When I had this type of patient we gave the finely crushed medications through the tube with flushing before and after.

    Being you are lucky enough that the patient is able to take the medication orally than yes keep the tube clamped.

     

    Teresa

     

    Nurse Case Manager

    815 N. Broadway Ave. Suite 155

    Tyler, TX 75702

    Phone: 903-510-5608

    Cell: 903-258-7502

    Fax: 903-535-0759

    tnowland@netphd.org

    www.healthyeasttx.com

     

     

    From: ntca.simplelists.com listserve [mailto:nobody@simplelists.com]
    Sent: Thursday, February 15, 2018 6:28 PM
    To: tbnurses@ntca.simplelists.com
    Subject: Daily digest for tbnurses@ntca.simplelists.com

     

    Administering PAS via G tube - Sabuwala, Nadya (MDH) (15 Feb 2018 18:13 EST)

    Administering PAS via G tube by Sabuwala, Nadya (MDH) (15 Feb 2018 18:13 EST)
    Reply to list

    Hello fellow nurse,

    1.      Are any of you familiar with or have any tips or resources regrading administering Pacer via a G tube?

    2.      Do you clamp the tube for a while after administering all TB medications through a G tube? If yes, for how long do you clamp the tube?

     

    Thanks for your help,

    Nadya

     

     

    Nadya Sabuwala PHN, RN, MSN, MPH

    Nurse Consultant
    Minnesota Department of Health
    Infectious Disease Epidemiology, Prevention and Control
    625 Robert Street N| P.O. Box 64975
    St. Paul, MN  55164-0975
    p (651) 201-5548 |  f (651) 201-5500

     

    To reply to a posting, simply reply. To start a new thread, address it to tbnurses@ntca.simplelists.com and put in a concise subject line. You are on the daily digest setting for the listserve.The archives for this list are at http://ntca.simplelists.com/tbnurses. If you have problems with the listserve, please contact Lorna Will at lwill@tbcontrollers.org

    To reply to a posting, simply reply. To start a new thread, address it to tbnurses@ntca.simplelists.com and put in a concise subject line. You are on the daily digest setting for the listserve.The archives for this list are at http://ntca.simplelists.com/tbnurses. If you have problems with the listserve, please contact Lorna Will at lwill@tbcontrollers.org 
To reply to a posting, simply reply. To start a new thread, address it to 
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for 
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact Lorna 
Will at lwill@tbcontrollers.org