Department of Clinical Nutrition Support Services, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nutr Clin Pract. 2021 Feb;36(1):111-132. doi: 10.1002/ncp.10615. Epub 2020 Dec 29.
The administration of medication through an enteral access device requires important forethought. Meeting a patient's therapeutic needs requires achieving expected drug bioavailability without increasing the risk for toxicity, therapeutic failure, or feeding tube occlusion. Superimposing gut dysfunction, critical illness, or enteral nutrition-drug interaction further increases the need for a systematic approach to prescribing, evaluating, and preparing a drug for administration through an enteral access device. This review will explain the fundamental factors involved in drug bioavailability through the gut, address the influencing considerations for the enterally fed patient, and describe best practices for enteral drug preparation and administration.
通过肠内途径给予药物需要深思熟虑。满足患者的治疗需求需要确保药物具有预期的生物利用度,同时不增加毒性、治疗失败或喂养管堵塞的风险。肠道功能障碍、危重病和肠内营养-药物相互作用的叠加进一步增加了系统地制定肠内途径给予药物的处方、评估和准备药物的必要性。本文将解释药物通过肠道实现生物利用度的基本因素,讨论肠内喂养患者的影响因素,并描述肠内药物准备和给药的最佳实践。