Macy catheter: Difference between revisions
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==History== |
==History== |
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The Macy Catheter was invented by Brad Macy, RN, a practicing [[hospice]] nurse for 20 years. Macy was inspired by a hospice patient who was terminally agitated and not responding to a solid form of a rectally delivered medication. Improvising, Macy administered the same medication in a semi-liquid form with a small tube inserted into the patient's [[rectum]]. The patient's agitation rapidly diminished, and the patient was sleeping within 30 minutes. |
The Macy Catheter was invented by Brad Macy, RN, a practicing [[hospice]] nurse for 20 years. Macy was inspired by a hospice patient who was terminally agitated and not responding to a solid form of a rectally delivered medication. Improvising, Macy administered the same medication in a semi-liquid form with a small tube inserted into the patient's [[rectum]]. The patient's agitation rapidly diminished, and the patient was sleeping within 30 minutes<ref>[http://www.mcknights.com/a-hospice-invention-that-stemmed-from-necessity/article/336221/ "A hospice invention that stemmed from necessity" McKnight's Long Term Care News (March 5, 2014)]</ref>. Subsequently, Macy worked with engineers and medical experts to design and develop the Macy Catheter<ref>{http://hospicorp.com/the-macy-catheter/the-macy-catheter-invention "The Macy Catheter Invention"</ref>. The device has two U.S. patents and received 510(k) clearance from the [[Food and Drug Administration]] in early 2014<ref>[http://www.mcknights.com/hospi-corporation-receives-clearance-for-catheter/article/334485/ "Hospi Corporation receives clearance for catheter" ''McKnight's Long Term Care News'' (February 18, 2014)]</ref><ref>[http://www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/510kclearances/ucm384648.htm "January 2014 510(k) Clearances" ''U.S. Food and Drug Administration''</ref>. |
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== References == |
== References == |
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Revision as of 19:41, 17 June 2014
Macy Catheter new article content ...
The Macy Catheter is an FDA-approved medical device designed for the rapid administration of medications via the rectal route. The catheter is a flexible tube that is passed through the anus and sits in the lower one-third of the rectum. Rectal drug delivery is an effective route of medication delivery for many medications used at the end of life[1][2][3][4][5][6][7], and the Macy Catheter facilitates that delivery.
Patients suffering from serious or terminal illness often need medication when the oral route is compromised [8]. Although intravenous administration is the most commonly used alternate route in acute care settings [9], it is rarely used in hospice care, given the associated cost and need for a high level of care and training for providers[10]. It can also lead to complications such as infection and pain[11]. Although subcutaneous medication delivery is more common in hospice, it is also expensive and can cause infection, pain and swelling[12]. The rectal route of administration is highly effective as the rectal mucosa is highly vascularized tissue that allows for rapid and effective absorption of medications[13][14][15][16][17][18][19]. The Macy Catheter provides a solution to overcome the challenges and leverage the benefits of rectal administration.
Medical Uses
The Macy Catheter provides an immediate way to control symptoms, such as pain and nausea when the oral route of medication administration is compromised. It is useful for patients who cannot swallow, including those at the end of life, or an estimated 1.65 million people estimated to be in hospice care each year[20] Because the Macy Catheter enables rapid administration of medications via the rectal route, it may also be applicable to care of patients in long-term care or palliative care, or those in traumatic situations who may not be candidates for intravenous or subcutaneous medication delivery.
Key Features and Functions
The Macy Catheter is a single-use disposable device, comprised of a dual-port dual lumen ballooned tube that is inserted by a clinician into the rectum just past the rectal sphincter, where the retention balloon is inflated to hold the device in place. Once inserted, the external portion of the Macy Catheter rests on the patient's leg or abdomen, where it is easily accessible for repeat administration of liquid medications in solution or suspension form, until the patient has a bowel movement and expels the retention balloon. The Macy Catheter medication port features a specialized valve to prevent leakage and is designed to be non-clogging and compatible only with the connectors on oral/enteral syringes (not luer syringes) for safety.
History
The Macy Catheter was invented by Brad Macy, RN, a practicing hospice nurse for 20 years. Macy was inspired by a hospice patient who was terminally agitated and not responding to a solid form of a rectally delivered medication. Improvising, Macy administered the same medication in a semi-liquid form with a small tube inserted into the patient's rectum. The patient's agitation rapidly diminished, and the patient was sleeping within 30 minutes[21]. Subsequently, Macy worked with engineers and medical experts to design and develop the Macy Catheter[22]. The device has two U.S. patents and received 510(k) clearance from the Food and Drug Administration in early 2014[23][24].
References
- ^ Davis MP, Walsh D, LeGrand SB, Naughton M. (2002) "Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions." Support Care Cancer. 10(2):117-38.
- ^ De Boer AG, Moolenaar F, de Leede LG, Breimer DD. (1982) "Rectal drug administration: clinical pharmacokinetic considerations." Clin Pharmacokinetics. 7(4):285-311.
- ^ van Hoogdalem EJ, de Boer AG, Breimer DD. (1991) "Pharmacokinetics of rectal drug administration, Part 1." Clin Pharmakokinet. 21(1):11-26.
- ^ van Hoogdalem EJ, de Boer AG, Breimer DD. (1991) "Pharmacokinetics of rectal drug administration, Part 2." Clin Pharmakokinet. 21(2):110-128.
- ^ Moolenaar F, Koning B, Huizinga T. (1979) "Biopharmaceutics of rectal administration of drugs in man. Absorption rate and bioavailability of phenobarbital and its sodium salt from rectal dosage forms." International Journal of Pharmacaceutics, 4:99-109.
- ^ Graves NM, Holmes GB, Kriel RL, Jones-Saete C, Ong B, Ehresman DJ. (1989) "Relative bioavailability of rectally administered phenobarbital sodium parenteral solution." DICP, The Annals of Pharmacotherapy, 23:565-568.
- ^ Moolenaar S, Bakker S, Visser J, Huizinga T. (1980) "Biophamacutics of rectal administration of drugs in man IX. Comparative biopharmaceutics of diazepam after single rectal, oral, intramuscular and intravenous administration in man." International Journal of Pharmaceutics, 5:127-137.
- ^ Use of Rectal Meds for Palliative Care Patients. End of Life / Palliative Education Resource Center, Medical College of Wisconsin
- ^ Yang H. 2013. "Intravenous Opioid Infusions in Comfort Care." The Institute for Palliative Medicine
- ^ Miller KE, Miller MM, Jolley MR. 2001. "Challenges in Pain Management at the End of Life" American Family Physician
- ^ Kagel EM, Rayan GM. 2004. "Intravenous catheter complications in the hand and forearm." J Trauma 56(1):123-7.
- ^ McPherson ML, Kim M, Walker KA. 2012. "50 practical medication tips at the end of life." J Support Oncol 10(6):222-9.
- ^ Davis MP, Walsh D, LeGrand SB, Naughton M. (2002) "Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions." Support Care Cancer. 10(2):117-38.
- ^ De Boer AG, Moolenaar F, de Leede LG, Breimer DD. (1982) "Rectal drug administration: clinical pharmacokinetic considerations." Clin Pharmacokinetics. 7(4):285-311.
- ^ van Hoogdalem EJ, de Boer AG, Breimer DD. (1991) "Pharmacokinetics of rectal drug administration, Part 1." Clin Pharmakokinet. 21(1):11-26.
- ^ van Hoogdalem EJ, de Boer AG, Breimer DD. (1991) "Pharmacokinetics of rectal drug administration, Part 2." Clin Pharmakokinet. 21(2):110-128.
- ^ Moolenaar F, Koning B, Huizinga T. (1979) "Biopharmaceutics of rectal administration of drugs in man. Absorption rate and bioavailability of phenobarbital and its sodium salt from rectal dosage forms." International Journal of Pharmacaceutics, 4:99-109.
- ^ Graves NM, Holmes GB, Kriel RL, Jones-Saete C, Ong B, Ehresman DJ. (1989) "Relative bioavailability of rectally administered phenobarbital sodium parenteral solution." DICP, The Annals of Pharmacotherapy, 23:565-568.
- ^ Moolenaar S, Bakker S, Visser J, Huizinga T. (1980) "Biophamacutics of rectal administration of drugs in man IX. Comparative biopharmaceutics of diazepam after single rectal, oral, intramuscular and intravenous administration in man." International Journal of Pharmaceutics, 5:127-137.
- ^ http://www.nhpco.org/sites/default/files/public/Statistics_Research/2013_Facts_Figures.pdf "National Hospice and Palliative Care Organization's Facts and Figures: Hospice Care in America, 2013 Edition"
- ^ "A hospice invention that stemmed from necessity" McKnight's Long Term Care News (March 5, 2014)
- ^ {http://hospicorp.com/the-macy-catheter/the-macy-catheter-invention "The Macy Catheter Invention"
- ^ "Hospi Corporation receives clearance for catheter" McKnight's Long Term Care News (February 18, 2014)
- ^ [http://www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/510kclearances/ucm384648.htm "January 2014 510(k) Clearances" U.S. Food and Drug Administration