FEATURES OF DRUG INTERACTIONS WITH PARENTERAL OR ENTERAL NUTRITION IN CONCURRENT USE (LITERATURE REVIEW)
Keywords:
drug interaction, parenteral nutrition, enteral nutrition, pharmacokineticsAbstract
The interaction of pharmaceuticals with components of nutritional mixtures, especially in parenteral and enteral nutrition, is a crucial aspect of clinical pharmacology that directly influences the effectiveness and safety of therapy. During the treatment of patients receiving specialized nutrition, interactions between drugs and nutritional components can alter the pharmacokinetic and pharmacodynamic properties of medications, impacting their bioavailability and therapeutic effectiveness. Incorrect combinations of drugs and nutritional mixtures may lead to serious side effects, reduced therapeutic efficacy, or even the development of toxic reactions. The article outlines the main mechanisms of drug interactions with components of parenteral and enteral nutrition, particularly with amino acid mixtures, lipids, and vitamin-mineral complexes. The study also addresses physicochemical incompatibilities that occur when drugs and nutritional components are used simultaneously, which may result in changes in drug stability, impaired bioavailability, or even the formation of harmful toxic compounds. Temperature conditions and types of containers used for parenteral nutrition solutions play an essential role in these interactions. Special attention is given to pharmacodynamic interactions, which can significantly affect therapeutic efficacy through alterations in drug metabolism within the body, potentially leading to increased toxicity or reduced drug effectiveness. Based on an analysis of current literature sources, the authors provide practical recommendations for healthcare professionals on how to avoid undesirable effects when combining drugs with nutritional mixtures. The article also presents methods for monitoring pharmacotherapy in patients receiving parenteral and enteral nutrition, highlighting the importance of considering individual patient characteristics when selecting medications and determining administration protocols. Furthermore, the impact of nutritional components on treatment outcomes in chronic diseases such as diabetes, cardiovascular diseases, and others is discussed, where complex treatment regimens involving both pharmacotherapy and nutritional support are frequently applied.
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