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连续肠内营养时药物使用的建议。

Recommendations for the use of medications with continuous enteral nutrition.

作者信息

Wohlt Paul D, Zheng Lan, Gunderson Shelly, Balzar Sarah A, Johnson Benjamin D, Fish Jeffrey T

机构信息

Department of Pharmacy, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84157, USA.

出版信息

Am J Health Syst Pharm. 2009 Aug 15;66(16):1458-67. doi: 10.2146/ajhp080632.

Abstract

PURPOSE

Recommendations for the use of medications with continuous enteral nutrition are provided.

METHODS

A literature review was conducted to identify primary literature reporting medication interactions with continuous enteral nutrition. For medications without supporting literature, manufacturers were contacted for information. Package inserts for specific medications were also investigated for any information to help guide recommendations. If no specific recommendations were made by the pharmaceutical manufacturer or the package insert concerning administration of products with continuous enteral nutrition, a tertiary database was consulted. Recommendations were generated by a consensus of clinicians for those medications that lacked specific recommendations in the primary literature or from the pharmaceutical manufacturer. Documentation of medication interactions with continuous enteral nutrition and food was then collated along with specific recommendations on how to administer the medication with regard to continuous enteral nutrition. Recommendations were classified as strong (grade 1) or weak (grade 2). The quality of evidence was classified as high (grade A), moderate (grade B), or low (grade C).

RESULTS

Forty-six medications commonly given to hospitalized patients were evaluated. Twenty-four medications had recommendations based on available data, and the remaining 22 medications had recommendations based on a consensus of clinicians.

CONCLUSION

There was a lack of published data regarding drug-nutrient interactions for a majority of the drugs commonly administered to patients receiving continuous enteral nutrition. Clinicians should recognize potential drug-nutrient interactions and use available evidence to optimize patients' drug therapy.

摘要

目的

提供使用药物与持续肠内营养的建议。

方法

进行文献综述以识别报告药物与持续肠内营养相互作用的原始文献。对于没有支持性文献的药物,联系制造商获取信息。还调查了特定药物的包装说明书以获取有助于指导建议的任何信息。如果制药商或包装说明书未就持续肠内营养产品的给药给出具体建议,则查阅三级数据库。对于在原始文献或制药商中缺乏具体建议的药物,由临床医生达成共识生成建议。然后整理药物与持续肠内营养和食物相互作用的文献记录以及关于如何在持续肠内营养时给药的具体建议。建议分为强(1级)或弱(2级)。证据质量分为高(A级)、中(B级)或低(C级)。

结果

对通常给予住院患者的46种药物进行了评估。24种药物根据现有数据有建议,其余22种药物根据临床医生的共识有建议。

结论

对于大多数接受持续肠内营养的患者常用药物,缺乏关于药物 - 营养相互作用的已发表数据。临床医生应认识到潜在的药物 - 营养相互作用,并利用现有证据优化患者的药物治疗。

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