143x Filetype PPT File size 0.19 MB Source: eclass.hua.gr
Effect of nutrient-devices on drugs • One of the most frequent drug-related problems in patients receiving clinical nutrition is drug interactions with enteral or parenteral nutrition, and inappropriate drug administration techniques Effect of nutrient-devices on drugs The problem (1) • Not much is known about drug and enteral or parenteral feed incompatibilities. This is due partly to the huge variability in composition of EN and, especially, TPN solutions, and the range and concentration of drugs which may be administered simultaneously Effect of nutrient-devices on drugs The problem (2) • One can find few things in current literature or in the manufacturer’s product summary, therefore most recommendations are theoretical • Usually, drugs are not licensed for administration in EN or PN, so pharmacists need to combine theory with empiricism, knowing that in most cases they cannot rely on published data to confirm the safety of their actions. Effect of nutrient-devices European Association of Hospital Pharmacists on drugs Amsterdam 2001 General mechanisms of interactions between nutrients and drugs (1) • stimulation of splachnic capillary blood flow (increase in first-pass effect) • chelation of drug molecules by minerals such as calcium and iron (eg. quinolones) • competing with the action of the drug (eg. warfarin-vita K) Effect of nutrient-devices on drugs General mechanisms of interactions between nutrients and drugs (2) • changing the pH of the GI tract to increase or decrease absorption • inhibiting or enhancing drug metabolism • changing GI motility to increase or decrease absorption • enhancing drug solubility
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