Cacek A T, DeVito J M, Koonce J R
Am J Hosp Pharm. 1986 Mar;43(3):689-92.
The effect on phenytoin recovery of various methods of nasogastric administration of phenytoin suspension was studied. Phenytoin acid suspension 4 mL (100 mg) was administered through a nasogastric (NG) tube using 10 methods designed to simulate clinical situations. The suspension was given either undiluted or diluted, with or without irrigation of the NG tube. Solutions of 5% dextrose injection, 0.9% sodium chloride injection, sterile water for irrigation, and lactated Ringer's injection were used as diluents or irrigants. After each administration, 40 mL of air was forced through the NG tube to expel any remaining suspension. Phenytoin concentration was assayed by high-performance liquid chromatography before and after administration through the NG tube. In the method that used no diluent or irrigation, 75.5 +/- 5.3% of the initial dose volume was lost, significantly more loss than with any of the other methods. The mean dose volume lost for all of the other nine methods was 6.4 +/- 3.4%. The type of fluid used for dilution or irrigation had little influence on phenytoin recovery. Until other methods can be evaluated, phenytoin suspension should be diluted and irrigated with at least 20 mL of fluid when given by nasogastric tube. Evacuation of the tube with 40 mL of air after phenytoin administration is also recommended.
研究了苯妥英钠混悬液不同鼻胃给药方法对苯妥英钠回收率的影响。使用10种旨在模拟临床情况的方法，通过鼻胃管给予4 mL（100 mg）苯妥英酸混悬液。混悬液可以原液或稀释液形式给药，鼻胃管可冲洗或不冲洗。5%葡萄糖注射液、0.9%氯化钠注射液、冲洗用无菌水和乳酸林格氏注射液用作稀释剂或冲洗液。每次给药后，通过鼻胃管注入40 mL空气以排出任何残留的混悬液。通过鼻胃管给药前后，采用高效液相色谱法测定苯妥英浓度。在不使用稀释剂或不冲洗的方法中，初始剂量体积的75.5±5.3%损失掉了，显著多于其他任何方法。其他九种方法的平均剂量体积损失为6.4±3.4%。用于稀释或冲洗的液体类型对苯妥英回收率影响很小。在能够评估其他方法之前，鼻胃管给药时苯妥英混悬液应用至少20 mL液体稀释并冲洗。建议苯妥英给药后用40 mL空气排空管道。
