If crushing is permitted, what safeguards must you follow?

• A. Use pharmacist-approved method, ensure dosage accuracy, and document the change; use an appropriate device.
• B. Ignore dosage calculations and proceed.
• C. Crush and mix with any beverage.
• D. Document after the next dose.

Answer: (A)

Crushing a medication changes how it releases and is absorbed, so safeguards must be followed to protect safety and effectiveness. Only crush it if the pharmacist or prescriber has approved a specific method for that drug, including how to prepare and administer it. This helps ensure the exact dose ordered is delivered, because crushing can introduce loss or uneven distribution if not done correctly. Using the pharmacist‑approved method also reduces the risk of altering the medication’s action, such as with certain formulations that must not be crushed. Documentation is essential—record that a dose was altered to a crushed form, the method used, the device, the time, and who performed it—so others understand the change and can maintain continuity of care. Employ the appropriate device designated for crushing to ensure complete transfer of the dose, proper particle size, and minimal contamination or exposure. If a medication is not crushable (for example, certain extended‑release or enteric‑coated forms), do not crush it and seek an alternative from the pharmacist or prescriber.