From the Guidelines
Paracetamol can be given via nasogastric (NG) tube, but it is crucial to follow proper administration guidelines to minimize risks and ensure effectiveness. When administering paracetamol via NG tube, it is recommended to use a liquid formulation rather than crushing tablets, as liquid forms are more easily absorbed and less likely to clog the tube 1. The standard adult dose is 500-1000mg every 4-6 hours, with a maximum of 4000mg in 24 hours. For children, dosing is weight-based, typically 10-15mg/kg every 4-6 hours.
Key Administration Considerations
- Pause any feeding for at least 30 minutes before and after giving the medication
- Flush the tube with at least 30 mL of water before and after administration, as recommended by the espen guideline on home enteral nutrition 1
- Ensure the medication is adequately diluted if using concentrated forms
- Avoid mixing medicines before administration through an enteral feeding tube due to risks including drug-drug interactions 1 Paracetamol works by inhibiting prostaglandin synthesis in the central nervous system and can effectively manage mild to moderate pain and fever when oral administration isn't possible. The NG route provides similar bioavailability to oral administration, making it an effective alternative when the oral route is unavailable.
Additional Considerations
- Adequate flushing of the tube between feed and/or medications is necessary to prevent tube occlusions 1
- Healthcare professionals should be aware of the potential risks and benefits of administering medicines through enteral feeding tubes and follow established guidelines to ensure safe and effective administration 1
From the Research
Administration of Paracetamol via Nasogastric Tube (NG)
- There is no direct evidence in the provided studies that specifically addresses the administration of paracetamol via a nasogastric tube (NG) 2, 3, 4, 5, 6.
- However, study 5 discusses the appropriateness of administration of nasogastric medication and preliminary intervention, which may imply that certain medications can be given via NG, but it does not specifically mention paracetamol.
- The other studies focus on the comparison of different routes of administration for paracetamol, such as rectal versus intravenous 2, intravenous paracetamol for fever management 3, and oral versus intravenous paracetamol in adults with fever 4.
- Study 6 provides a general overview of antipyretic analgesics, including paracetamol, but does not discuss the administration of paracetamol via NG.
- In summary, there is no direct evidence to support or refute the administration of paracetamol via NG, and further research would be needed to determine its safety and efficacy 2, 3, 4, 5, 6.