Reasons for unpredictable response
Drugs may bind to the enteral feeding tube, resulting in reduced absorption and bioavailability of the drug.
Examples:
Nutrients in the enteral feed may increase or decrease absorption of the drug from the stomach. This will consequently affect the drug levels in the body.
- - Highly protein bound drugs such as theophylline may interact with the protein content of the feed. This may result in decreased effects.
- - Some drugs may be required to be taken on an empty stomach e.g. flucloxacillin, tetracyclines. Tetracyclines may bind to some components of the feed, causing a decrease in the bioavailability of the drug.
- - Digoxin interacts with enteral feeds which are high in fibre such as Jevity®
Diarrhoea can be a problem in post-pyloric feeding. This is partly because the jejunum lacks the reservoir effect provided by the gastric fluids in the stomach and partly because the protective action of the pylorus in the regulation of delivery of nutrients into the intestine is bypassed.3 Many liquid medications are hyperosmolar or hypertonic, and when administered directly into the jejunum osmotic diarrhoea and nausea can occur.6
Every reasonable attempt has been made to ensure that the information on this site is accurate and up to date. Betsi Cadwaladr University Local Health Board (East) does not authorise or take responsibility for any off-license use of medication, which should only be done with prescriber agreement.
Copyright © 2024 J Smyth, Betsi Cadwaladr University Local Health Board (East). All rights reserved
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