A stroke patient with swallowing difficulties is obtaining nutrition through enteral formula. A nurse called the pharmacy to enquire about the administration of the following medications to the patient via NG feeding tube. He is prescribed aspirin enteric coated 80 mg QD, nifedipine SR (Adalat retard) 20 mg BD, rosuvastatin 5 mg QD, TNG 1 tablet stat PRN, and lansoprazole delayed release capsules 30 mg QD.

a) Comment on whether the following formulations can be given by nasogastric tube. Please state the potential concerns and what advice should the pharmacist provide

i) Enteric coated (4 marks)

ii) Extended release (5 marks)

iii) Sublingual tablets (2 marks)

b) As the patient is also receiving enteral nutrition, the nurse asks if the medications (that can be administered via enteral route) could be added directly to the enteral formula. Please comment on the potential concerns and advise the nurse on how to prevent complications. (4 marks)

*Please note: QD means ONCE A DAY*