Tablet mill may cause problems

1. milling process, because of the need to add some excipients, such as: lactose or starch, which may result in sub- Each package after package of Uneven; and if the patient suffered from a history of lactose intolerance, then take with added lactose excipients in powder, the prone to the problem of diarrhea and other gastrointestinal discomfort. <span title="

2.磨粉后的药粉，因为不易辨识而容易造成拿取时服用错误。” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

2. Powders after milling, as difficult to get recognition and likely to cause an error when taking. <span title="

3.因为磨粉的机器没有完全清理干净，导致上一位病人与下一位病人的药品交互污染。” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

3. Because the milling machine is not completely clean, leading to the next patient, a patient with drug cross contamination. <span title="

4.磨粉时，因为会将原本的剂型破坏，而造成药品本身制剂的安定性改变，进而导致药品成分容易受到空气湿度影响，而” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

4. Flour, because the original formulation will be destroyed, resulting in the stability of pharmaceutical agents to change their own, which led to pharmaceutical ingredients susceptible to air humidity, and deliquescence modification to efficacy weakened. <span title="

5.舌下锭(Sublingual tablets)：例如用来治疗急性心绞痛发作的硝化甘油(Nitroglycerin 0.6mg；Nitrostat)，其剂型设计是经由口腔所分布的丰富血流直接” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

5. Sublingual tablets (Sublingual tablets): for example, for the treatment of acute angina attack nitroglycerin (Nitroglycerin 0.6mg; Nitrostat), the oral dosage form designed by the distribution of wealth through direct blood flow absorption, put in the sublingual solution. If the chew, swallow or milling no such effect, even life-threatening emergency. <span title="

6.对于一些“特殊剂型设计”的药品，例如：

(1)持续释放型药品(商品名后有下列缩写字母：CR、LA、SR、” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

6. For some “special dosage form design” drugs, such as:

(1) sustained-release drugs (brand name after the initials of the following: CR, LA, SR, SA, TR, TD, or XL, etc.): Pharmaceutical ingredients after grinding may cause instant total dose release, and produce blood concentrations of the drug treatment of instability, could easily happen Drug toxicity, side effects caused by drugs. <span title="例如：

a.忧郁症治疗及戒烟辅助的药品──Bupropion SR 150mg属于持续性药效锭，需整粒吞服，不可咀嚼、剥半或磨粉；假如经磨粉” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>For example:

a. treatment for depression and smoking cessation aids drug ─ ─ Bupropion SR 150mg tablets are sustained efficacy, need to swallow, whole, not chewed, peeling and a half or flour; if by milling later, probably because of rapid absorption, and convulsion, nausea, dry mouth, constipation and other side effects. <span title="

b.降血压用药──Indapamide SR 1.5mg属于持续释放锭，需整粒吞服，不可咀嚼或磨粉，但可剥半；假如经磨粉后，可能因吸收过” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

b. blood pressure medication ─ ─ Indapamide SR 1.5mg sustained release tablets are required to swallow, whole, not chewing or grinding, but can be stripped and a half; if by the mill, may absorb too because fast, and hypotension phenomenon. <span title="

c.摄护腺肥大症治疗用药──Alfu-zosin XL 10mg属于三层释放药效锭，需整粒吞服，不可咀嚼、剥半或磨粉；假如经磨粉” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

c. treatment of benign prostatic hyperplasia drug ─ ─ Alfu-zosin XL 10mg tablets are three release efficacy, need to swallow, whole, not chewed, peeling and a half or flour; if by milling later, probably because of rapid absorption, and palpitations, dizziness and other side effects. <span title="

d.用于缓解气喘及支气管痉挛的支气管扩张剂──Theophylline SRMC 125mg属于持续释放胶囊，需整粒吞服，不可咀嚼或磨粉，但可剥半；假如经磨” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

d. for the relief of asthma and bronchospasm bronchodilators ─ ─ Theophylline SRMC 125mg sustained release capsules are required to swallow, whole, not chewing or grinding, but can be stripped and a half; if by grinding powder, it may cause rapid heartbeat, palpitations, and gastrointestinal disorder, seizure onset and other side effects. <span title="

(2)肠溶衣或膜衣剂型的药品： 磨粉后可能造成药品成分受胃酸的影响而无法到达作用部位或失去药效，也可能引起肠胃道的刺激性。” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

(2) enteric coating or film coating formulations of drugs: pharmaceutical ingredients after grinding may cause can not be affected by the impact of acid at the site, or lose its efficacy, may also cause gastrointestinal irritation. <span title="例如：

a.用于缓解便秘的用药──Bisac-odyl 5mg属于肠溶糖衣锭，需整粒吞服，不可咀嚼、剥半或磨粉；因为是经由小肠才能吸收” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>For example:

a. medication used to relieve constipation ─ ─ Bisac-odyl 5mg enteric coated tablets are required to swallow, whole, not chewed, peeling and a half or flour; because it can be absorbed through the small intestine If after milling, the potency is destroyed, it will stimulate gastric motility, while nausea, vomiting and stomach cramps and other side effects. <span title="

b.消化性溃疡治疗用药──Esome-prazole 40mg属于肠膜衣锭，需整粒吞服，不可咀嚼、剥半或磨粉，但可将药品溶于水中管灌” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

b. treatment of peptic ulcer medication ─ ─ Esome-prazole 40mg film coated tablets are intestinal, be swallowed, whole, not chewed, peel half or flour, but drugs can be dissolved in the water pipe irrigation ; because it is absorbed by the bloodstream through the small intestine reach the parietal cells, thus inhibiting gastric acid secretion, if by the mill, the casing is damaged because of component Er Shi drugs destroyed by stomach acid and thus affect the efficacy. <span title="

c.用于治疗葡萄球菌、链球菌、肺炎双球菌、脑膜炎球菌及其它具有感受性细菌引起之感染症的抗生素用药──Ery-thromycin stearate 250mg属于膜衣锭，需” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

c. for the treatment of staphylococcus, streptococcus, pneumococcus, meningococcus, and other susceptible strains of bacterial diseases caused by antibiotic medication ─ ─ Ery-thromycin stearate 250mg film coated tablets are required to Intact swallow; as vulnerable to acid damage, if by the mill, it might affect the efficacy. <span title="

7.其它不适宜磨粉的药品，例如：对口腔黏膜刺激性大、味道苦涩、容易染色等。” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

7. Other suitable milling of drugs, such as: oral mucosa irritation big, bitter taste, easy dyeing. <span title="

结语

在欧美国家对于药品不当磨粉归类为不适当的处方调剂，目前台湾部分医院也有提倡推动药品不事先磨” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

Conclusion

in the United States and Europe for drugs classified as inappropriate flour improper dispensing prescriptions, some hospitals in Taiwan have advocated promoting drugs without prior grinding Powder policy. Who can not swallow or be self-feeding infants and young children or the elderly drug and other needs can not swallow or tube feeding of patients, how to take drugs? <span title="

1.首先须了解目前正在使用的药品是否适合磨粉，假如不确定，建议可向药师询问。” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

1. We must first understand whether the drugs currently being used for milling, if uncertain, it is recommended to ask the pharmacist. <span title="

2.在病人吃药前才以压碎方式搭配温水服用，磨粉的药品应在短时间内服用完毕。” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

2. In the patient medication ago to crush the way with warm water taking, milling taking drugs should be completed in a short time. <span title="

3.记得“单次服用，单次磨粉”的原则，也就是在单次服药前才将药品取出，并使用包药纸包覆，再用铁汤匙或玻璃杯” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

3. Remember “a single oral dose, a single mill” principle, that is, a single out before taking the drugs only to, and use the package drug coated paper, then iron spoon or glass the drugs crushed into powder. People can buy their own drugs milling cutting device to facilitate use. <span title="

（摘自台湾《健康世界》2010年8月号文／郁弘药师、詹璧玮药师(台湾马偕纪念医院)）” onmouseover=”this.style.backgroundColor=’#ebeff9′” onmouseout=”this.style.backgroundColor=’#fff’”>

(taken from Taiwan, “Health World” in August 2010 No. text / Yu Hong pharmacists, pharmacists Zhanbi Wei (Taiwan, Mackay Memorial Hospital))