When administering sucralfate (Carafate) to a patient with a nasogastric tube, it is important to:
A. Crush the tablet into a fine powder before mixing with water.
B. Administer with a bolus tube feeding.
C. Allow the tablet to dissolve in water before administering.
D. Administer with an antacid for maximum benefit.
Correct Answer: C. Allow the tablet to dissolve in water before administering.
It is important to give sucralfate on an empty stomach so that it may dissolve and form a protective barrier over the gastric mucosa. Sucralfate exhibits its action by forming a protective layer, increasing bicarbonate production, exhibiting anti-peptic effects, promoting tissue growth, regeneration, and repair.
Option A: The tablet form will not dissolve in water when crushed; it must be left whole and allowed to dissolve. Crushing the medication so that it will not dissolve could lead to clogging of the nasogastric tube and decreased effectiveness of the drug.
Option B: Sucralfate is a basic aluminum salt of sucrose octasulfate. When given orally, it disintegrates in the stomach in the presence of acid and binds to normal and damaged mucosa forming a protective layer. It releases aluminum and binds to positively charged compounds like proteins, peptides, glycoproteins, and glyco lipoproteins, forming an adhesive layer, thereby protecting the mucosa.
Option D: It prevents hydrolysis by preventing the formation of the enzyme-substrate complex. It adsorbs to pepsin and decreases its concentration. By forming a polyanion gel, it acts as a physical barrier between luminal contents and mucosa. It increases prostaglandin-dependent and independent production of bicarbonate by stomach and duodenum.
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