Gura K M
Children's Hospital, Boston, MA 02115.
Hosp Pharm. 1993 Mar;28(3):221-3, 227-8, 231-42.
With the increasing use of intravenous drug therapy in the pediatric population, pharmacists are frequently faced with questions concerning appropriate methods of parenteral drug delivery. In some instances, these patients are also receiving parenteral nutrition solutions, and often have a limited fluid capacity caused by disease states such as congestive heart failure or renal insufficiency. Limited vascular access is also a frequent concern in the treatment of these patients. As a result, pharmacists are frequently asked whether a medication may be administered along with the PN solution. Although this practice is strongly discouraged, in many cases, especially in the pediatric patient, it is the only way to ensure that the patient is receiving adequate nutrition as well as appropriate drug therapy. Also, by administering medication with the PN solution, rather than interrupting the PN to administer medication, the patient is less likely to develop rebound hypoglycemia. The practice of administering medication through a central venous line intended for PN solutions is not without risks, however. Catheter sepsis and occlusion may result.
随着静脉药物治疗在儿科人群中的使用日益增加，药剂师经常面临有关肠外给药合适方法的问题。在某些情况下，这些患者也在接受肠外营养溶液，并且由于诸如充血性心力衰竭或肾功能不全等疾病状态，其液体容量往往有限。有限的血管通路也是这些患者治疗中经常令人担忧的问题。因此，药剂师经常被问及一种药物是否可以与肠外营养溶液一起给药。尽管强烈不鼓励这种做法，但在许多情况下，尤其是在儿科患者中，这是确保患者获得足够营养以及适当药物治疗的唯一方法。此外，通过将药物与肠外营养溶液一起给药，而不是中断肠外营养来给药，患者发生反弹性低血糖的可能性较小。然而，通过用于肠外营养溶液的中心静脉导管给药并非没有风险。可能会导致导管败血症和堵塞。
