Magnuson Barbara L, Clifford Timothy M, Hoskins Lora A, Bernard Andrew C
University of Kentucky College of Pharmacy, Lexington, KY 40536, USA.
Nutr Clin Pract. 2005 Dec;20(6):618-24. doi: 10.1177/0115426505020006618.
The enteral route has become the standard of care to deliver nutrition support for hospitalized acute care and ambulatory care patients. The same access device is increasingly being used to deliver medications, which provides cost savings but also creates new challenges. Cost savings can be negated if the concomitant administration of nutrition elicits a decrease in bioavailability due to incompatibilities that alter drug or nutrition therapy. Feeding tubes can deliver nutrients and drugs to the stomach, small bowel, or both, with optimal efficacy of medications depending on delivery to the appropriate segment of the gastrointestinal tract. Liquid preparations are often the preferred formulation for enteral administration. Obstruction of the enteral access device may occur when specialized medication formulations are altered inappropriately. Occasionally, the enteral formula should be changed to modify the content of free water, fiber, electrolytes, or vitamins that may interfere with the drug therapy. Intolerance to enteral nutrition such as abdominal distention and diarrhea may be the result of the medication, and the causative agent should be identified to improve patient comfort. This article will address optimal drug delivery via enteral access devices and possible complications associated with therapy.
肠内途径已成为为住院急性护理和门诊护理患者提供营养支持的护理标准。越来越多地使用同一给药装置来给药，这既能节省成本，但也带来了新的挑战。如果由于不相容性导致营养物质的同时给药引发生物利用度降低，从而改变药物或营养治疗，那么节省的成本可能会被抵消。饲管可将营养物质和药物输送至胃、小肠或两者，药物的最佳疗效取决于输送至胃肠道的适当节段。液体制剂通常是肠内给药的首选剂型。当特殊药物制剂被不恰当地改变时，可能会发生肠内给药装置堵塞。偶尔，应更改肠内配方以调整可能干扰药物治疗的游离水、纤维、电解质或维生素的含量。对肠内营养不耐受，如腹胀和腹泻，可能是药物所致，应确定病因以提高患者舒适度。本文将探讨通过肠内给药装置实现最佳药物输送以及与治疗相关的可能并发症。
