Australian Don’t rush to crush handbook. 1st edition

Society of Hospital Pharmacists of Australia, Collingwood, Vic: SHPA; 2011.
647 pages
Price: $120 ($110 for members of the SHPA)

This is the first edition of Don’t rush to crush, by the Society of Hospital Pharmacists of Australia. It is focused on providing a comprehensive selection of Australian-based medication monographs to guide healthcare professionals in the safe administration of medications to people unable to swallow solid oral medicines. It is not designed to replace the approved product information, it is a companion to the clinical decision-making process.

The handbook introduction provides a comprehensive outline of the problems and implications of medication-swallowing difficulties and the alteration of solid oral medications for both general patients and those having enteral feeding. There is a description of the common methods used to alter medications, medications that shouldn’t be crushed and a section focusing on the specifics of administering medicines to people with swallowing difficulties or enteral feeding tubes. This section is particularly useful clinically as it contains decision trees and administration flow charts to assist with the practicalities of altering and administering the medications, including preparation details for dispersible tablets, crushed tablets and dispersible capsules.

A great strength of the monographs themselves is their simplicity. Aside from the usual details including generic and brand names, strength and dosage form, a symbol-based quick guide allows the user to easily identify whether a product can be dispersed, crushed, not crushed, is hazardous or cytotoxic, or if it is available as a liquid formulation. For each monograph, specific advice is given for both enteral feeding and general swallowing difficulties.

This handbook would be a valuable resource in all clinical settings including hospital, rehabilitation services, aged care, domiciliary care and general practice. It is practical and comprehensive, and its Australian-based monographs make it the most worthwhile reference source of this kind available and a ‘must have’ for anyone working with medications.