Zuccari Guendalina, Macis Sara, Alfei Silvana, Marchitto Leonardo, Russo Eleonora
Department of Pharmacy, University of Genoa, Viale Cembrano, 16148 Genoa, Italy.
Hospital Pharmacy, Department Technical Health, San Paolo Hospital, Via Genova, 17100 Savona, Italy.
J Pers Med. 2022 Aug 12;12(8):1307. doi: 10.3390/jpm12081307.
Usually, the administration of drugs by feeding tube in dysphagic patients involves handling of marketing licenses outside their term, due to the lack of suitable formulations. This circumstance has put health professionals in the dilemma of choosing the formulation whose manipulation possibly does not alter the effectiveness of the drug. In this regard, a practical guide providing indications on the prescription, handling, and administration of drugs through enteral feeding tube could be of paramount utility. For this purpose, we have considered the 1047 solid oral pharmaceutical forms included in the formulary of San Paolo Hospital (Savona, Italy). From our analysis, it emerges that 95% of medicinal products are worryingly used off-label and 40% have to be managed by the hospital pharmacists without having suitable indications by either the manufacturers or by literature studies. To fill this gap, we have compiled a detailed table containing missing indications derived from pharmacist expertise and evidence-based practices, with the aim that the sharing of our procedures will contribute to make uniform pharmacological therapies from one hospital to another. This study will allow doctors to have easy access to information on drugs that can be prescribed and nurses to become familiar only with the pharmaceutical forms that can be administered.
通常，吞咽困难患者通过鼻饲管给药时，由于缺乏合适的剂型，往往涉及超适应症使用药品许可的情况。这种情况使医疗专业人员陷入两难境地，即要选择一种操作方式可能不会改变药物疗效的剂型。在这方面，一份关于通过肠内营养管给药的处方、处理和管理的实用指南可能具有至关重要的作用。为此，我们研究了圣保罗医院（意大利萨沃纳）处方集里包含的1047种固体口服药物剂型。从我们的分析中可以看出，令人担忧的是，95%的药品存在超适应症使用的情况，40%的药品必须由医院药剂师处理，而制造商或文献研究均未给出合适的用药说明。为填补这一空白，我们编制了一份详细表格，其中包含从药剂师专业知识和循证实践中得出的缺失用药说明，目的是分享我们的操作流程，有助于使各医院之间的药物治疗趋于统一。这项研究将使医生能够轻松获取可开具药物的信息，并使护士仅熟悉可给药的药物剂型。
