Pill Crushers

 

Pill crushers have been around for a long time with extensive use by apothecaries. The mortar and pestle pill crusher is a symbol for many pharmacies even today but currentlyrarely used by pharmacists. The mortar is the bowl, and the grinding handle is the pestle. Apothecaries would grind herbs and medicines in the mortar to formulate a custom prescription for each patient.

 

Today, pill crushing takes place in hospitals, nursing homes, or the patient’s home. For inpatient care, the use of crushed tablets for administration is largely due to patient swallowing difficulties or the refusal to swallow tablets.¹ Acetaminophen is the most commonly crushed tablet in hospitals because of its difficulty with swallowing.²

 

Several medical studies of pill crushing devices have found that there can be a significant loss of medication between the crushing to patient consumption stages with some devices. One medical study noted the importance of rinsing the crushing device twice and the patient’s direct consumption of the crushed medication along with the rinse to receive as much of the prescribed medication as possible.³

 

Additionally, some studies have found that there are some medications not suitable for crushing. For instance, extended-release or slow-release medications, skin or membrane irritants, as well as foul-tasting pills, are not good candidates for crushing. A list of these medications is at the following link: "Oral dosage forms that should not be crushed."⁴

 

• Aids patients that are unable to swallow large tablets
• Aids patients that refuse to take tablets
• Smashing pills is fast and easy with the right device.
• Disposable cups and pouches reduce dosage loss.
• Most devices are portable.
• May be mixed with food or drink.

 

• Some devices require dexterity and strength from patients that may be frail.
• Patient compliance may be an issue for some patients.
• Risk of incorrect dosing.
• Potential dosage loss.
• Potential patient non-compliance due to additional efforts.
• Requires thorough cleaning between use to prevent possible cross-contamination.

• Mortar and Pestle – is an antique, apothecary two-piece system made with silicone, porcelain, hardwood, stainless steel, or stone. Requires labor, but offers easy cleanup.
• Twist Screw Type – most popular and least expensive, place your pill in the chamber, twist the knob and crush. Use of this product requires some dexterity on the part of the user.
• Scissor Type – position the tablet in the jaw of the scissors, bring the handles together, and the tablet divides into two equal parts.
• Lever Type – employs a lever to apply force to crush tablets. Place pills into a bag to prevent cross-contamination. The bag goes into a slot, press down on the lever to crush the pills.
• Mill Grinder – place pill in the chamber, turn the handle to activate the crushing mechanism.
• Electric Crushers – place tablet in the chamber, close lid, and press a button.
• Crushing Syringe – crushes tablets, mixes with liquid and then administers liquified medication for enteral feeding.

 

 

Grinders and lever type crushers commonly employ the use of disposable cups or disposable bags for containment and for patient administration of the medication. Manual grinders use disposable bags to contain the medication while electric pill grinders use disposable cups to capture the crushed medication and to administer it to the patient.