1.Drug-nutrient Interactions in Elderly Patients.
Journal of Clinical Nutrition 2014;6(1):11-18
Physiological changes associated with aging affect the absorption, distribution, metabolism, and excretion of drugs and thus therapeutic outcomes. These changes may be further amplified by interactions with nutrients. The purpose of this review was to summarize drug-nutrient interactions found in elderly patients. Mechanisms of the interactions can be categorized as ex vivo bio-inactivations, interactions in absorption and elimination phases, and physiological interactions. The goal of enteral nutrition (EN) is to maximize the therapeutic response of medication without adversely affecting EN tolerance. Therefore, to ensure safety, consistent monitoring is necessary for enteral feeding of patients receiving medication via an enteral tube. Elderly patients receiving parenteral nutrition (PN) are often treated concomitantly with medication via the parenteral route. The stability and compatibility of PN formulations infused with other additives, including medication, may be influenced. Limitation of the number of prescriptions to essential medications only during the minimum period along with periodic re-evaluations of the treatment are thus necessary to minimize undesirable drug-nutrient interactions in elderly patients.
Absorption
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Aged*
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Aging
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Enteral Nutrition
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Food-Drug Interactions
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Humans
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Metabolism
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Nutritional Support
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Parenteral Nutrition
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Prescriptions
2.The Influence of Pediatric Nutrition Support Team on Hospitalized Pediatric Patients Receiving Parenteral Nutrition
Sijin BAEK ; Juhyun RHO ; Hyung Wook NAMGUNG ; Eunsook LEE ; Euni LEE ; Hye Ran YANG
Journal of Clinical Nutrition 2020;12(1):7-13
Purpose:
Malnutrition is a common problem in hospitalized patients that can increase the risk of complications, including infections and length of hospitalization. Appropriate nutritional support is important, particularly in pediatric patients, because growth and development are closely related to the nutritional supply. This study examined the status of nutritional support for pediatric patients in general wards to determine if interventions of the pediatric nutrition support team (pNST) contribute to appropriate nutritional support and help improve their nutritional status.
Methods:
Between July 2016 and June 2017, all pediatric inpatients who received parenteral nutrition support at the Seoul National University Bundang Hospital were recruited and divided into the NST group and non-NST group according to the activities of pNST. The nutritional status was assessed in all subjects, and the calories and proteins delivered through nutritional support in each group were calculated and then compared with the recommended requirements in pediatric patients.
Results:
The number of patients recruited was 174: 100 (57.5%) in the NST group and 74 (42.5%) in the non-NST group. Significantly more calories and protein were supplied in the NST group than the non-NST group in hospitalized children aged between four and 17 years (P<0.05). In the non-NST group, the amounts of calories supplied were insufficient compared to the recommended requirements. The proportion of patients supplied with the appropriate number of calories was 60.0% in the NST group and 20.0% in the non-NST group (P<0.001), and the proportion of cases supplied with the appropriate amount of protein was 87.0% in the NST group and 62.2% in the non-NST group (P<0.001).
Conclusion
Interventions of the pediatric nutrition support team contributed to the sufficient supply of calories and protein and the improvement of clinical outcomes in hospitalized children on parenteral nutrition therapy.
3.Developing national level high alert medication lists for acute care setting in Korea
Ji Min HAN ; Kyu-Nam HEO ; Ah Young LEE ; Sang il MIN ; Hyun Jee KIM ; Jin-Hee BAEK ; Juhyun RHO ; Sue In KIM ; Ji yeon KIM ; Haewon LEE ; Eunju CHO ; Young-Mi AH ; Ju-Yeun LEE
Korean Journal of Clinical Pharmacy 2022;32(2):116-124
Background:
High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting.
Methods:
We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS).We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys.
Results:
From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group.
Conclusion
We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.