管饲给药的临床评估与操作建议  

Assessment and administration methods of drug administrating via enteral feeding tubes

作　　者：甄晓慧[1] 甄荣荣 单悌超[3] 孙德清[1] 王荣梅[1] 薛霞[1] 

机构地区：[1]山东大学第二医院药学部,山东济南250033 [2]山东省肿瘤医院放疗科,山东济南250117 [3]山东大学齐鲁医院重症医学科,山东济南250012

出　　处：《中国新药与临床杂志》2017年第2期114-120,共7页Chinese Journal of New Drugs and Clinical Remedies

基　　金：山东省药学会临床药学中青年科研项目(Sdpa-ask-2013-06)

摘　　要：临床上当患者采用管饲营养时,药物也常从此途径输入胃肠道。管饲给药与经口服药存在显著的不同,给药不当会导致管路堵塞、药效降低、不良反应增加等。管饲给药前需要考虑管饲通道的材质、内径、开口位置,同时评估药物剂型的适用性。一般首选液体制剂,其次选择易崩解或可研碎的固体制剂,不推荐选择肠溶包衣及缓控释制剂。给药时需对药物剂型进行妥当处理,选择适当的给药剂量和时间,给药前后注意冲管。密切监测患者临床反应,必要时调整给药剂量。操作者应按照规范的流程进行给药操作,以最大程度保证管饲给药疗效、减少药物治疗相关并发症。When patients use enteral feeding tubes for nutrition delivery, drugs may also be administered via this route. Drug administrating via feeding tubes is different from oral route. Incorrect administration methods may result in clogged feeding tubes, decreased drug effectiveness and increased adverse effects. The material,diameter and tip location of tube feeding channel should be considered before tube feeding, at the same time,the applicability of the evaluation of drug dosage forms should be carefully evaluated. Liquid dosage formulations are generally preferred. Most solid immediate- release products including those sugar- or film- coated that can be crushed may be used for administration via feeding tubes. Enteric- coated and extended- release products are not appropriate. Proper doses and times should be chosen according to clinical pharmacology. Dosage formulations should be appropriately prepared and feeding tubes should be properly flushed with water before and after drug delivery. Patients must be monitored for the expected clinical response to medication and doses adjusted accordingly. Administrating drugs according to the standardized operation reduces the complications of drug administration without decreasing drug activity.

关 键 词：肠道营养 喂饲方法 给药途径 剂型 药物利用 

分 类 号：R969.3[医药卫生—药理学] R452[医药卫生—药学]