Pill thru j tube

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natelaugh
Posts: 95
Joined: Wed Apr 03, 2019 11:40 pm

Pill thru j tube

Postby natelaugh » Thu Dec 05, 2019 11:27 pm

I need help. My dad has a cancer blockage at the duodenum. He got his GJ tube to bypass the blockage and it is working. He needs to get encorafenib and binimetinib but it is in pill form and he can't take by mouth. The Kaiser pharmacy don't have a safe way to give my dad encorrafenib and binimetinib thru his j tube. They say there is no study or any information on how to do it.

1,) Do anyone know a study or a method that Kaiser pharmacy can do it?

2.) Can radiation work on v600e mutation? We are thinking to use radiation to shrink the tumor so there is enough room to take the pill thru mouth.

Please give some feedback. Thx.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

martd
Posts: 117
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: Pill thru j tube

Postby martd » Fri Dec 06, 2019 8:46 am

Any possibility of dissolving the pill in a small amount of water and taking it in liquid form?
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT Tp53 LOF
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9
04/19 clear scan CEA .9
07/19 clear scan CEA 1.0

natelaugh
Posts: 95
Joined: Wed Apr 03, 2019 11:40 pm

Re: Pill thru j tube

Postby natelaugh » Fri Dec 06, 2019 9:43 am

martd wrote:Any possibility of dissolving the pill in a small amount of water and taking it in liquid form?

Hi,

Kaiser pharmacy say it has not been done before and don't know a safe way of doing it. I thought if pill can be crush in small particles then mix in water and feed it thru j tube.

Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

martd
Posts: 117
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: Pill thru j tube

Postby martd » Fri Dec 06, 2019 10:39 am

Most likely it's beyond the pharmacy to make that call. Have you discussed it with the doctors? They might ok with it or feel it's safe enough to try.
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT Tp53 LOF
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9
04/19 clear scan CEA .9
07/19 clear scan CEA 1.0

KimT
Posts: 676
Joined: Sat Feb 20, 2010 8:53 pm

Re: Pill thru j tube

Postby KimT » Fri Dec 06, 2019 11:04 am

I am a nurse and this is based on my own experience. Pills are meant to be digested in the stomach and absorbed in the intestines. When you crush them, it can change the absorption rate and efficacy. Some pills cannot be crushed at all. You have the added issue of a j tube. The problem with putting things in a j tube is that it passes the stomach completely and digestion. That also can change the efficacy and absorption. The stomach is where it gets broken down into a state where it can be absorbed.

In my opinion, pharmacists are more knowledgeable about drugs in general. They are definitely more knowledgeable about interactions and absorption rates etc. The buck stops with the pharmacist in my experience and if they say it cannot be done, that is likely the case.
2/10 dx colon cancer
right hemicolectomy 3/19/10
Stage 2a 0/43 nodes
Lynch syndrome
3/14/10 colon resection/ removal of metal clips
Nov 11 dx ovarian cancer


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