Which statement indicates a safety concern when a client on antihypertensive therapy says, 'I crush my verapamil SR to make it easier to swallow'?

Which statement indicates a safety concern when a client on antihypertensive therapy says, 'I crush my verapamil SR to make it easier to swallow'?

• A. I crush my verapamil (Calan SR) to make it easier to swallow.
• B. I move it to a different time of day.
• C. I take it with a full glass of water.
• D. I only take it when I feel chest pain.

Answer: (A)

Crushing a sustained-release version of verapamil defeats its designed release pattern. Verapamil SR is meant to release the drug slowly over time, maintaining steady blood levels. If the tablet is crushed, the entire dose can flood the system at once, causing a dangerous spike in drug levels that can lead to severe hypotension, bradycardia, and possible heart block. This safety risk is specific to altering the release mechanism of the formulation. The other behaviors don’t involve breaking the sustained-release design. Moving the dose time can be acceptable if it still provides consistent coverage, taking the medication with a full glass of water is appropriate, and taking it only when chest pain occurs ignores chronic management and is not a pharmacokinetic safety issue of the tablet form itself.

Crushing a sustained-release version of verapamil defeats its designed release pattern. Verapamil SR is meant to release the drug slowly over time, maintaining steady blood levels. If the tablet is crushed, the entire dose can flood the system at once, causing a dangerous spike in drug levels that can lead to severe hypotension, bradycardia, and possible heart block. This safety risk is specific to altering the release mechanism of the formulation.

The other behaviors don’t involve breaking the sustained-release design. Moving the dose time can be acceptable if it still provides consistent coverage, taking the medication with a full glass of water is appropriate, and taking it only when chest pain occurs ignores chronic management and is not a pharmacokinetic safety issue of the tablet form itself.