肠内营养乳剂与乙酰半胱氨酸泡腾片相互作用的临床观察  

Clinical Observation of the Interaction Between Enteral Nutrition Emulsion and Acetylcysteine Effervescent Tablets

作　　者：邸海灵[1] 于泽芳 贾海波[2] 俞丹[1] 邵海嵘 仝天 张新月 方灵芝[2] 史英钦[2] DI Hailing;YU Zefang;JIA Haibo;YU Dan;SHAO Hairong;TONG Tian;ZHANG Xinyue;FANG Lingzhi;SHI Yingqin(Department of Clinical Nutrition,The Third Hospital of Hebei Medical University,Shijiazhuang 050050,China;Department of Pharmacy,Hebei Provincial People's Hospital,Shijiazhuang 050050,China;School of Public Health,Hebei Medical University,Shijiazhuang 050050,China)

机构地区：[1]河北医科大学第三医院临床营养科,石家庄050050 [2]河北省人民医院药学部,石家庄0150050 [3]河北医科大学公共卫生学院,石家庄050050

出　　处：《中国现代应用药学》2025年第3期465-468,共4页Chinese Journal of Modern Applied Pharmacy

摘　　要：目的总结和分析2例肠内营养乳剂TPF-D与乙酰半胱氨酸泡腾片在临床同时应用后导致食道堵塞的病例,并进行体外实验初步探讨其相互作用机制及影响因素,为临床药物应用提供科学依据。方法通过体外实验模拟临床条件,将TPF-D与不同浓度的乙酰半胱氨酸溶液混合,系统监测混合溶液的物理性状变化及pH值,以评价其相互作用。结果乙酰半胱氨酸加入TPF-D后导致混合溶液pH值下降,TPF-D溶液随之变黏稠并形成沉淀。当pH值降至3.97时,混合溶液完全凝固。此外,泡腾片剂型的乙酰半胱氨酸与TPF-D混合后溶液的pH值较颗粒剂型更低,更易形成沉淀物。结论TPF-D与强酸性的乙酰半胱氨酸溶液之间存在明显的配伍禁忌。临床使用时应避免将TPF-D与乙酰半胱氨酸泡腾片等强酸性药物一起使用,以防止食道堵塞等并发症的发生。OBJECTIVE To summarize and analyze the information of 2 cases of enteral nutrition emulsion TPF-D and acetylcysteine effervescent tablets that caused esophageal blockage after clinical application at the same time,and carrie out in vitro experiments to initially explore their interaction mechanism and influencing factors,aiming to provide scientific basis for clinical drug application.METHODS TPF-D was mixed with acetyl cysteine solution of different concentration through in vitro experiment to evaluate the interaction.The physical properties and pH value of the mixture were monitored systematically.RESULTS It was observed that the pH value of the mixed solution decreased after the addition of acetylcysteine to TPF-D,and the TPF-D solution became viscous and precipitated.When the pH value drops to 3.97,the mixed solution was completely solidified.In addition,the pH value of the solution of acetyl cysteine mixed with TPF-D in effervescent tablets was lower than that of granules,and it was easier to form precipitate.CONCLUSION There is an obvious incompatibility between TPF-D and strongly acidic acetylcysteine solution.Concomitant use of TPF-D with strongly acidic medications,such as acetylcysteine effervescent tablets,should be avoided in clinical practice to prevent complications like esophageal obstruction.

关 键 词：肠内营养乳剂 TPF-D 乙酰半胱氨酸泡腾片 配伍禁忌 

分 类 号：R969.3[医药卫生—药理学]