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Enteral Nutrition and Drug Administration, Interactions, and Complications

Barbara L. Magnuson, PharmD^*,, Timothy M. Clifford, PharmD^*,, Lora A. Hoskins, RD, MS and Andrew C. Bernard, MD^,

^* University of Kentucky College of Pharmacy, University of Kentucky College of Medicine, Division of General Surgery, Section of Trauma and Critical Care, Critical Care Nutrition Support Team, University of Kentucky Chandler Medical Center, Lexington, Kentucky

Correspondence: Barbara L. Magnuson, PharmD, Associate Professor, University of Kentucky College of Pharmacy, Nutrition Support Service, Coordinator, University of Kentucky Chandler Medical Center, 800 Rose Street, C-117, Lexington, KY 40536. Electronic mail may be sent to blmagn0{at}email.uky.edu.

The enteral route has become the standard of care to deliver nutrition support for hospitalized acute care and ambulatory care patients. The same access device is increasingly being used to deliver medications, which provides cost savings but also creates new challenges. Cost savings can be negated if the concomitant administration of nutrition elicits a decrease in bioavailability due to incompatibilities that alter drug or nutrition therapy. Feeding tubes can deliver nutrients and drugs to the stomach, small bowel, or both, with optimal efficacy of medications depending on delivery to the appropriate segment of the gastrointestinal tract. Liquid preparations are often the preferred formulation for enteral administration. Obstruction of the enteral access device may occur when specialized medication formulations are altered inappropriately. Occasionally, the enteral formula should be changed to modify the content of free water, fiber, electrolytes, or vitamins that may interfere with the drug therapy. Intolerance to enteral nutrition such as abdominal distention and diarrhea may be the result of the medication, and the causative agent should be identified to improve patient comfort. This article will address optimal drug delivery via enteral access devices and possible complications associated with therapy.

Nutrition in Clinical Practice, Vol. 20, No. 6, 618-624 (2005)
DOI: 10.1177/0115426505020006618


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