관급식 튜브를 통해 투여되는 약물의 적절한 제형 선택을 위한 개선 활동
Improvement Activities for Appropriate Selection of Dosage Form of Drugs Administered via Enteral Feeding Tube
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참고문헌
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초록
Enteral nutrition is indicated in patients unable to ingest nutrients orally but whose gastrointestinal function is adequate for digestion and absorption via enteral feeding tube. They are administered oral drugs via this tube. However, pharmaceutical problems may occur at this time. Therefore, prescription status of patients who administered enteral nutrition and certain drugs(oral drugs including dosage forms of extended-release drugs, enteric-coated drugs, dispersible tablets, powder and syrup) concurrently from 1st August to 3rd September of 2008 in Asan Medical Center was monitored. And experiment was conducted to know whether granules of extended-release capsules and enteric-coated capsules block tubes of size 16/14/8fr. As tube blocking and administration errors revealed in case of PPIs, we attempt to prescription intervention to alter enteric coated PPIs into dispersible PPI. The results shows that granules of all capsules pass through tubes of 16fr and 14fr, except Losec capsule® and Eryc capsule®, respectively. However, granules of all capsules block tube of 8fr. In 13 cases of prescription intervention of PPIs, 6 cases are altered into dispersible PPI and 7 cases are not altered. By this activity, we know that medical practitioners lack information on various dosage forms and man-to-man intervention is difficult due to the time and procedure. Based on this study, we suggest guidelines for appropriate selection of dosage form to enteral feeding patients. This may help successful medical treatment for enteral feeding patients.
Abstract
Enteral nutrition is indicated in patients unable to ingest nutrients orally but whose gastrointestinal function is adequate for digestion and absorption via enteral feeding tube. They are administered oral drugs via this tube. However, pharmaceutical problems may occur at this time. Therefore, prescription status of patients who administered enteral nutrition and certain drugs(oral drugs including dosage forms of extended-release drugs, enteric-coated drugs, dispersible tablets, powder and syrup) concurrently from 1st August to 3rd September of 2008 in Asan Medical Center was monitored. And experiment was conducted to know whether granules of extended-release capsules and enteric-coated capsules block tubes of size 16/14/8fr. As tube blocking and administration errors revealed in case of PPIs, we attempt to prescription intervention to alter enteric coated PPIs into dispersible PPI. The results shows that granules of all capsules pass through tubes of 16fr and 14fr, except Losec capsule® and Eryc capsule®, respectively. However, granules of all capsules block tube of 8fr. In 13 cases of prescription intervention of PPIs, 6 cases are altered into dispersible PPI and 7 cases are not altered. By this activity, we know that medical practitioners lack information on various dosage forms and man-to-man intervention is difficult due to the time and procedure. Based on this study, we suggest guidelines for appropriate selection of dosage form to enteral feeding patients. This may help successful medical treatment for enteral feeding patients.
참고문헌 (6)
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- Gramlich L, "Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature", Nutrition, 20(10), pp.843~848 (2004)
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- van den Bemt PM, "Quality improvement of oral medication administration in patients with enteral feeding tubes", Qual Saf Health Care, 15(1), pp.44~47 (2006)
- Williams NT, "Medication administration through enteral feeding tubes", Am J Health Syst Pharm, 65(24), pp.2347~2357 (2008)
- Lourenco R, "Enteral feeding: drug", nutrient interaction, 2001, pp.20(2), 187~193