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PAUL D. WOHLT, PHARM.D., is Critical Care Pharmacist, Department of Pharmacy, Intermountain Medical Center, Murray, UT. LAN ZHENG, PHARM.D., is Staff Pharmacist, Department of Pharmacy, University of California at Irvine Medical Center, Orange. SHELLY GUNDERSON, PHARM.D., is Clinical Pharmacist, Department of Pharmacy, University of Kansas Medical Center, Kansas City, MO. SARAH A. BALZAR is a student, School of Pharmacy, University of Wisconsin—Madison, Madison. BENJAMIN D. JOHNSON, PHARM.D., is Clinical Pharmacist; and JEFFREY T. FISH, PHARM.D., is Senior Clinical Pharmacist, University of Wisconsin Hospital and Clinics, Madison.

Address correspondence to Dr. Wohlt at the Department of Pharmacy, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84157 (paul.wohlt{at}imail.org).

Purpose. Recommendations for the use of medications with continuous enteral nutrition are provided. Methods. A literature review was conducted to identify primary literature reporting medication interactions with continuous enteral nutrition. For medications without supporting literature, manufacturers were contacted for information. Package inserts for specific medications were also investigated for any information to help guide recommendations. If no specific recommendations were made by the pharmaceutical manufacturer or the package insert concerning administration of products with continuous enteral nutrition, a tertiary database was consulted. Recommendations were generated by a consensus of clinicians for those medications that lacked specific recommendations in the primary literature or from the pharmaceutical manufacturer. Documentation of medication interactions with continuous enteral nutrition and food was then collated along with specific recommendations on how to administer the medication with regard to continuous enteral nutrition. Recommendations were classified as strong (grade 1) or weak (grade 2). The quality of evidence was classified as high (grade A), moderate (grade B), or low (grade C). Results. Forty-six medications commonly given to hospitalized patients were evaluated. Twenty-four medications had recommendations based on available data, and the remaining 22 medications had recommendations based on a consensus of clinicians. Conclusion. There was a lack of published data regarding drug–nutrient interactions for a majority of the drugs commonly administered to patients receiving continuous enteral nutrition. Clinicians should recognize potential drug–nutrient interactions and use available evidence to optimize patients’ drug therapy. Index terms: Drug interactions; Nutrition

 

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