CHU Clermont-Ferrand, Pharmacie, Hop G Montpied, 58 rue Montalembert, F-63000 Clermont-Ferrand, France.
Int J Pharm. 2010 May 10;390(2):160-4. doi: 10.1016/j.ijpharm.2010.01.040. Epub 2010 Feb 2.
Proton pump inhibitors (PPIs) are largely prescribed to children because their efficacy and tolerance are now well-established. One disadvantage resides in the absence of liquid form which causes problems for their administration in nasogastric tubes. Indeed, the absence of use recommendations involves many misuses responsible for inefficiency and/or tube obstruction. We tried to evaluate if PPIs can be administered through pediatric nasogastric tubes. We administered four PPIs (Omeprazole, esomeprazole, lansoprazole and lansoprazole orally disintegrating tablet) through nasogastric tubes. For each PPI a study plan was drawn up to assess the influence of different variables: the volume of water to dissolve or put in suspension the PPIs (2ml or 5ml), the volume of tube flush-through water post-PPI administration (2ml, 5ml or 10ml), the length (50cm or 125cm) and the diameter (6 or 8 French) of the polyurethane tubes. For each assay an analysis of each active ingredient at the tube outlet by UV spectrometry was carried out. All 6 F tubes were obstructed by PPIs. Through 8 F tubes, we observed a mean recovery of active ingredient of 86.2% for lansoprazole orally disintegrating tablet, 36.9% for esomeprazole but only 7.1% for lansoprazole and 3.9% for omeprazole. It is disadvised using omeprazole and lansoprazole through 8 F nasogastric tubes because no condition ensures the transit of an efficient concentration of active ingredient. For esomeprazole, the best conditions of administration were a water volume of 5ml and a rinse volume of 5ml but only a half of the microgranules administered were recovered. The most satisfactory results were obtained with lansoprazole orally disintegrating tablet. A 5ml volume of water diluent for suspension and a 10ml volume of flush-through water made it possible to deliver the full lansoprazole dose administered.
质子泵抑制剂（PPIs）在儿童中广泛应用，因为其疗效和耐受性已得到充分证实。但也存在一些缺点，比如缺乏液体制剂，这导致其在经鼻胃管给药时存在困难。事实上，由于缺乏使用建议，导致了许多不合理用药的情况，从而导致疗效不佳和/或胃管堵塞。我们尝试评估质子泵抑制剂是否可以通过小儿经鼻胃管给药。我们通过鼻胃管给予四种质子泵抑制剂（奥美拉唑、埃索美拉唑、兰索拉唑和兰索拉唑口崩片）。对于每种质子泵抑制剂，我们制定了一个研究计划，以评估不同变量的影响：溶解或混悬质子泵抑制剂所需的水量（2ml 或 5ml）、质子泵抑制剂给药后冲洗管的水量（2ml、5ml 或 10ml）、管的长度（50cm 或 125cm）和管的直径（6 或 8 法国）。对于每种检测，我们通过紫外分光光度法在管出口处对每种活性成分进行分析。所有 6F 管均被质子泵抑制剂堵塞。通过 8F 管，我们观察到兰索拉唑口崩片的活性成分回收率平均为 86.2%，埃索美拉唑为 36.9%，但兰索拉唑仅为 7.1%，奥美拉唑为 3.9%。不建议使用 8F 鼻胃管给予奥美拉唑和兰索拉唑，因为没有条件能确保有效浓度的活性成分通过。对于埃索美拉唑，最佳给药条件是水体积 5ml 和冲洗体积 5ml，但只有一半的微丸被回收。兰索拉唑口崩片的结果最令人满意。使用 5ml 水稀释剂混悬液和 10ml 冲洗液，可以输送所给予的全部兰索拉唑剂量。
