Usefulness in Nasogastric Tube Blockage by Addition of Food Thickener to Suspension of Depakene^® Fine Granules 40%

Abstract

Depakene^® fine granules (Depakene) that contain 40％ sodium valproate have a high sedimentation rate and poor suspension dispersibility. Administration of Depakene suspension via a commonly used nasal 8-Fr outer diameter feeding tube results in tube blockage. The study aimed to determine if the addition of thickened food to Depakene would prevent tube blockage observed with Depakene suspension alone. We tested a 1 g / 20 mL Depakene suspension with the addition of various concentrations of thickened food and measured the dissolution profile and tube passage amounts of sodium valproate. When the concentrations of thickened food were ≤ 2％, the dissolution profile and tube passage amount of sodium valproate were not affected. In a questionnaire survey on the sensation of injecting the Depakene suspension into a tube, most respondents said that a 0.38％ thickened food concentration was the “easiest to inject,” with infrequent tube blockages. Since the plunger pressing force for the 0.38％ thickened food concentration was about 12 N, it was regarded as the load that an adult woman could easily inject into the tube. To summarize, we found that a thickened food concentration of 0.38％ effectively prevented tube blockage of a 1 g / 20 mL suspension of Depakene.