Which medication may be crushed only with special permission?

The medication that may be crushed only with special permission is one that typically requires a doctor's order. This is because certain medications are designed to be released in a specific manner when ingested, and crushing them could alter their effectiveness or lead to undesirable side effects. For example, some medications are enteric-coated to protect them from stomach acid and to ensure that they dissolve in the intestines instead. Crushing these types of medications can not only compromise their intended release mechanism but also increase the risk of side effects or decreased efficacy.

When medications require a doctor's order for their administration, it indicates that the healthcare provider has assessed a patient's condition and determined the appropriate course of treatment. Altering the form of these medications without explicit permission from the prescribing healthcare provider can lead to complications. Therefore, it is crucial to obtain special permission before crushing any medications that fall under this category to ensure patient safety and effectiveness of the treatment.