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5 Dedicatoria: A Dios por brindarnos las fuerzas para alcanzar nuestras metas y objetivos y por estar siempre a nuestro lado en los momentos difíciles A nuestros Padres: José y Amanda Gabino y Maria Por su incondicional amor dedicación y confianza A Nuestros hermanos: Elena Otto y José Luis A nuestro asesor por la orientación y apoyo en el desarrollo de nuestra tesis. Muchas gracias Q.F. José Juárez Eyzaguirre A nuestra asesora, por su apoyo incondicional, consejos y valiosa amistad. Q.F. Maria Ocaña Pacheco A nuestro asesor, maestro y amigo por la orientación y apoyo en el inicio de nuestra tesis, Q.F. Fernando Quevedo Ganoza A los miembros de la Unidad de Soporte Nutricional Artificial y Metabólico, por su colaboración en la realización de nuestra tesis A todas aquellas personas que nos apoyaron en el desarrollo de nuestra tesis: Q.F. Gladis Delgado, Dr. Mario Ferreira, Q.F. Casilda Huanca, Q.F. Gladis Sosa, Q.F. Daniel Maguiña, Q.F Jeny Pascal, Q.F. Hernán Montalvo, Q.F. Víctor Izaguirre, Q.F. Rosa Toro, Q.F. Maria Rosa Gutiérrez. A nuestros entrañables amigos colegas de la promoción 2001: Rocio S., Gino, Jesica, Amy 1

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7 El objetivo del presente estudio fue registrar y evaluar las potenciales incompatibilidades e interacciones medicamento nutriente enteral artificial (IIMNEA); evaluar y comparar los resultados obtenidos mediante entrevistas al personal de enfermería sobre la técnica de administración con las recomendaciones aportadas por las investigadoras. El diseño del estudio fue observacional, descriptivo, longitudinal. Se realizó en el Hospital Nacional Edgardo Rebagliati Martins (EsSalud) en pacientes que recibían terapia farmacológica y nutrición enteral artificial a la vez. Se estudiaron 100 pacientes de los cuales 66 cumplieron los criterios de inclusión; detectándose en ellos 290 casos de potenciales IIMNEA, donde 232 fueron interacciones farmacodinámicas; 56 farmacocinéticas; 1 incompatibilidad física y química; 1 caso de incompatibilidad farmacéutica; no se presentaron casos de interacción potencial fisiológica. De la entrevista al personal de enfermería responsable de la administración de medicamentos y la nutrición enteral se encontró que el 94% de enfermeras entrevistadas usan técnicas incorrectas de administración de medicamentos a través de sondas de alimentación enteral, además no toman en cuenta el mecanismo de absorción del medicamento. Estos resultados demuestran la importancia que tiene el Farmacéutico para evitar potenciales IIMNEA. En base al análisis de los fármacos más prescritos en pacientes que recibieron nutrición enteral artificial, se propone una guía para facilitar la administración de medicamentos a través de sondas y evitar potenciales IIMNEA. Palabras claves: Nutrición enteral, sondas de nutrición enteral artificial, administración de medicamentos, incompatibilidades e interacciones medicamento-nutriente enteral artificial. 3

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9 The purpose of the present study was register and test the potential incompatibilities and interactions drug-artificial nutrient enteral (IIDANE); evaluating and comparing the results, which were reached by inquiries to the Nurse s Staff about administration techniques of drug in accord with the investigators recommendations. The study s design was observational, descriptive and longitudinale. The study was made at the Edgardo Rebagliati Martins Hospital (EsSALUD), with patients which had both a pharmacology therapy and artificial enteral nutrition. A hundred patient were studied, which 66 were accord with the inclusion s criteria; detecting in these 290 cases of potentials IIDANE, where 232 were pharmacodinamic interaction which 56 were pharmacokinetic interactions; one case of fisical and chemistry incompatibility; one case of pharmaceutical incompatibility; in this study didn t find cases of potential physiology interaction. About the inquiries to the physiology interaction. About the inquiries to the Nurse s Staff, which were responsible of the drugs administration and enteral nutrition, was found that the 94% of nurses used wrong techniquies of drugs administration for tubes enteral feeding. Moreover, they didn t take in consideration the mechanism of drug s absorption. These results show the importance of the Pharmacist to avoid potential IIDANE. In support of the analysis of the most prescribed drugs to patients, which were given artificial enteral nutrition, was elabored a guide to facility the drugs administration by tubes and avoid potentials IIDANE. Key words: enteral nutrition, tubes of artificial enteral nutrition, drugs administration, incompabilities and drug-artificial enteral nutrient inter 5

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20 ! " # " $ # #! "! % "!! & # &! # " A $9 D $& #B ;W :$% J?$& # $< "#( # &"? < % &" "# # " & # # % & # "%! $F &?$ A $9 #?J $& #B ; # 9 # # "% %?"% H" I $ < "? : $9 $?D $& # &"? &"% :"&$ A BC? ; <#?$E% #" : % $"%" P%? %&? $I$& & $ $? "# J : ;? : :" $& # :"? %$#: # <# $I # &$#:$% $& #( % #? %H % C # %!E : # $%&$? & #? %&??$& & % E:$? ;W! %?$ % &" $% "# $% &" 9 & #" "%? "% " #"I" :"% " &$#:$% $& #" "G $" % " # &" :$#: ( # I"FC #"? #$!$? % "%' " & # " &$? # % : "$? #C? ;? % "%$& "$? "# &" 11>1LY &" "%" 9 AR$? # % "$? # 9 : # &" %$ E9"% : ; &" 12OB( " & # " &$? " "$? #C? ;? % "%$& "$? "# # " $ 1LY &" "%" 9 AR$? # % "$? # 9 : # &" %$ E9"% :"% &" 12OB ;C # " & # : % :D $? # & "# &" :$% J?$& # A&$" # " ":"% "#B? ; ": " I$"%" "? %$FJ%& #"? %& "0$# " < ":J $? &$9"# $I A# %& :" &" $% "# $%? C %? " $ $#C "%!" :"& & $%! : $ $% "# $% B( < " # 24 " %?$ ; I"% H? % "# "? # &$" # $:D $? # "0$# "? % I" #$ ( /373/37 '# # " "! " &": # &$# $%9 $ " & #? %!$< G " # % &$" # $:D $? # G " %!$< &$" D $? C "%! : &" $#?J $& # &" : FC # H C!$< 9 ; # I & :$? %$F & ( : "% #? $ " $ # &" "G $ $< $ % $?$ % ( $ &"!$< I &" % # " & # #( # J% $%&$? & #C #"9P% " $ &"!$< ; "& :$%$ # < " $%# < " "% " :$"% &" &$ " ; &" "# "M$:$"% "# "? $I :"% "( # " & E%$? % :$% J?$& # "%! : &" :"F? #? % "& :$%$ &" G " # &"? &"% :$!$? & ' "?$% C $# "?$% ; I $% C? % :"% " &" # :J $? # "% %?$E% #$:$ $&" & $#@" " " $% I"% # ( % $? # # &"? < % "% % "# $%9$& " &" " "? $ #( " $%&$? % "# "?!$? :"% " "% G " #?$"% "#? % "%!" :"& J $? G " &"# % 24 "%?"! ( # " & # %"!? E%$? #"?? " $F % G "? % $& & &" %$ E9"% A " % #B "# J $:$ & ; "%! : &" :$% J?$& # "#"%?$ "# 24 $&$% # % $? # # &"? < % ; " " &" " "? $ # "# : ; < H ( % "# " & #" $%? ;"% &$" # "# "?$ "#?$"% "#? % " %?$ % : 9? # C &$" # "# "?$ "# $:D $? #?$"% "# $%: % &" $:$& #C &$" # "# "?$ "# $:D $? #?$"% "#? % ; &$" # "# "?$ "# 24 #$?$ %"# &" "# D#( / : " : "!6& " ; 6! "! # 6 #!! 8 (9 : #" # <" "? 9 # $% "# $% "# J % $: :"% " $%I? & :" # #$# :" <E $? ( # $%?$ "#! %?$ %"# &"? 9 # $% "# $% G "!"? % # #$# ": # $%? ;"%' 17 $9"# $E% ; <#?$E% &" % $"% "# "? "?$E% : % # ; D $& #? % "!"? # "%&? $% #C? $% # ; %"? $% # % &" KO LO Y &" &" #?D #? "# #"? " # &"

21 3 ) $%: % 9 < $% "% " "H$& $%! $&" #?$ &? % " $% "# $% (?$ % % < "? % %#??$E% &" "% " E9"% # ID# &" &??$E% &" $%: % 9 < $% A 9 B #"? " ; &" :?$% "&$ "% " $% "? :<$ &" # # #?@ # &" # <"%"!$?$ # #?$ & #? % # % " "# & &$ "? &" $%! "%?$ G " "H"?"% # # # # $% :$% "# : % "%" $% "9 $& & &" :? # 9 # $% "# $% C : % "%" :" <E $? :"% " "# " E 9 % "% # # &$!" "% "# 12 % $"% "#C!$#$ 9 C! %?$ % $& & 9 # $% "# $% ; "% # "%!" :"& &"#? $? #( "! %?$ % :$"% &"? & &" :" < $#: C " 9 %$#: "G $" " &" # # # #?$ % & # &$9"# $E% ; <#?$E% &" # % $ $"% "#? % "%$& # "% # $:"% # T?"# & #U " < &$9"# $I ( &$9"# $E% "# "?"# :"&$ % " "? # : D? # 9 %&"# $%9" $& #? % &$" #" &$I$&"% "% : D? # :J# "G "M #C I"?@ < "# # "% "?$ #( % "? # &" # 9 # #C &$9"# $E% $: $? :<$D%? %I" #$E% # # %?$ # < "#( <#?$E% "# "?"# "? # # # %?$ # "# % "# &" &$9"# $E% # % &" 12 F $% "# $%?$??$E% ; $%!J $? ID# &" :? # ( # :"? %$#: # # G " # # # %?$ #? F % # :":< % # &" # " $?$ # # % &" "# $ #' &$! #$E% #$: "C &$! #$E%!?$ $ & ; %# "? $I ( 9! ;?$E% "% G " #" <# <"% &$!" "% "# # # %?$ # "% " $% "# $% "# J% &" " :$% & #!? "#? : # <$ $& &( # # # %?$ # < "# $"%&"% <# <" #" "% " $% "# $% &" 9 & 0$: ; # $ # < "# "% " ;"; % &$# C % I"F G % #$& # <$ $F & # <$ $#( # G " # % &" "# : "? &" #: $& & #" <# <"% &$# :"% "C D# # "G $" "% &" %?"# &$9"# $I? : $? & C % &" % $": :J# %9 & &" J%#$ $% "# $% ( & C : 9%$ & &" $"9 # %9 %" $% "# $% :<$D% $%! ;" "% <#?$E% &" # % $": "#( : % # G " $%? ":"% % "! H &" # %9 " $% "# $% C? :? "?$#?$%$% C %? "?$:$% ; #"? " $%! I "?"% <#?$E%- " "H"?$?$ ; " "# &? $? &"?@ G "C G " 12 &$#:$% ;"% "! #$E% $% "# $% $:$ % <#?$E%( /3731 # #<" " <" " 6#! # 6 #! #?? " # $? #! #$? # &" % $?$E% "% "? : #: $& &C? 9 "% &" # #C " /C " "#$& C I$#? #$& & ; &"%#$& &? E $? $"%"??$ %"# $: % "# "% "# "# &"?$"% " %!E : "# "?!$? ( #? : $??$ %"#? : &$ " C %J #" C IE:$ C &$# "%#$E% <& :$% ; %" : % # $?$E%C #" "&"% "?$ % 24? % #?? " # $? #! #$? #( /37313 "!! #: $& &? "# %&" %P:" &" #: "# &"? # A# #B "% % R$ 9 : &" # I"% "( #: $& & #" "!$" " %P:" &" #: "# $ &" #?$E% A# I"% " &":J# &" # B( G $"? : %"% " &" &$" # < " "% 9? % $< ;" #: $& & &" 1K

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51 1( %? #! :?D $? # " $% " % # &" :?$ C $? :"% " &"% &"?"# &" &:$%$#?$E% &" % $?$E% "% " ; &" # :"&$? :"% #- ; G " "# J% "%??$& & &" # 9" $? "? &:$%$#?$E% &" :"&$? :"% C "? :<$ &"! :! :?D $? C "% # &"!"? " # &" :"&$? :"% " % $I? %& #" "? # ( 2( $%&??$?$E% " # % &" "%!" :" "# %# < " &" &:$%$#?$E% &" % $?$E% "% " ; :"&$? :"% #C "I$ "%?$ "# ( 4K

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53 4 4 ) E 4 4 ) E Abad F, Valle J. Interacciones entre alimentos y fármacos. Servicio de Farmacología Clínica del Hospital Universitario de la Princesa, España Anonymous. Drug-Nutrient Interaction. JPEN, Journal of Parenteral and Enteral Nutrition, Supplement: Guideline for the use of Parenteral and Enteral Nutrition 2002; 26(1). Belknap D. Administration of medications through enteral feeding catheters, American Journal Critical Care1997; 6(3): Buchner F. Manual de farmacología clínica 2 edición, editorial Salvat. Barcelona Castillo M. Evaluación de la calidad higiénica sanitaria en fórmulas de nutrición enteral usadas en dos hospitales de la ciudad de Lima. Tesis para optar al titulo de Químico Farmacéutico. Facultad de Farmacia y Bioquímica, UNMSM. Lima, 2002 Cerulli J, Malone M. Assessment of drug-related problems in clinical nutrition patients, JPEN, Journal of Parenteral and Enteral Nutrition 1999; 23(4):218. Cohen H. Medication errors-a system problem, Today s Surgical Nurse 1988; 20(6). Day R. Cómo escribir y publicar trabajos científicos. 2 edición, OPS, Domenec J, Berrozpe J. Biofarmacia y Farmacocinética Vol II. Editorial Síntesis S.A. España. Cáp. I, IX. Douglas C, Denise G. Diarrhea with Enteral Feedings: prospective reappraisal of putative causes applied nutritional investigation. Nutrition 1994; 10(5). 4N

54 ! " # " $ # #! "! % "!! & # &! # " Duveiller V. Cliniques universitaires Saint-Lue - UCL Les interactions aliments-médicaments chez les patients äges, Symposium "Nutrition er alimentation de la personne äge" FELANPE. Manual Del Programa Terapia Nutricional Total, Cuidado integral del paciente. Capítulo 13. Santa Fé de Bogotá, Ferryera M, Holguín R. Sobre los antecedentes, consecuencias, variedad y aplicaciones farmacológicas de los nutrientes enterales en el Perú. Revista Gastroenterología 1999; Vol19: Fuchs V. Interacción fármaco-nutrición enteral, Nutrición Clínica 1999; suplemento1:s9-s12. Gilbar P. A guide to Enteral Drug Administration in Palliative Care. Journal of Pain and symptom Management 1999; 17(3): Goodman & Gilman. Las bases farmacológicas de la terapéutica. novena edición, editorial McGraw-Hill Interamericana. Capítulos 1, 2, 37, 38, 43, Gómez V. Normas Sencillas para nutrir precozmente a su paciente de forma barata y natural MIO 2002; 2(2):178. Goni R, Sánchez L. Drug Administration trough enteral feeding catheters. Enfermería Intensiva April 2001;12(2): Hamish, Munro, Gunter, Nutrition of elderly, Vol 29 Nestlé nutrition, Workshop series. Pg Heimburger D, Sockwell, J Geels. Diarrhea with enteral feeding, Prospective Reappraisal of putative causes. Nutrition 10 (5). Hospital Nacional Edgardo Rebagliati Martins. Guía de diagnóstico y tratamiento de medicina interna 1988; Lima-Perú,. IPSS. Protocolo de Soporte Nutricional Artificial. Lima-Perú Izco N, Creus J, Codina C. Incompatibilidades fármaco-nutrición enteral: recomendaciones para su prevención. Farmacia Hospitalaria 2001; 25(1): Jimenez V. Mezclas intravenosas y nutrición artificial. 4ta Edición, Editorial Convanser, Valencia España Joncas M. L'administration des médicaments par les sondes d'alimentation enterale: probléme ou défi? Pharmacothérpie théorique 2000; 33 (6): Johnson D. Drug-Nutrient considerations for Enteral Nutrition, In: Souba W III et al (eds). The ASPEN Nutrition Support Practice Manual. Silver Spring MD: American Society for Parenteral and Enteral Nutrition Kane, R, Geriatría clínica, 3 edición, Editorial Mac Graw Hill Interamericana. México Kelley K, Thechniques for administering oral medications to critical care patients receiving continuouns enteral nutrition, American Journal Health-System1999; 56: Laurenco R, Enteral Feeding: Drug/Nutrient Interaction, Clinical Nutrition 2001; 20(2): Lechuga G. Clopés E, Importancia de las características físico-químicas de los 5O

55 4 4 ) E fármacos por sonda nasoentérica o enterostomía, Barcelona, Farmacia Hospitalaria 1998; 22: Lingtak-Neander Chan. Drug-Nutrient Interaction in Transplant Recipients. Journal of Parenteral and Enteral Nutrition 2000; 25 (3): Litter M, Compendio de Farmacología, 4 Edición, Editorial El Ateneo Martinez M, J. Vázquez, G. Piñeiro Corrales,Estudio nutricional en pacientes geriátricos (mayores de 65 años) con nutrición enteral ambulatoria, correlación entre patología de base, aporte nutricional y tratamiento farmacológico, Nutrición Hospitalaria 2002; 17(3): Mc Connel E, Giving metications through and enteral feeding tube. Clinical Do s & Don ts.nursing, Pg Miller D, Miller H, To crush or not crush, Nursing, 2000; 30(2): Montejo JC, Jímenez J, Complicaciones gastrointestinales de la nutrición enteral en el paciente crítico, Medicina Intensiva 2000; 25(4): Montejo JC, Gónzales C, Administración de medicamentos por sonda nasogástrica en pacientes que reciben nutrición enteral: Elaboración de una guía práctica, Nutrición Hospitalaria 2000; 15: Picó, R, Pinedo R. Dieta y Neurología bases de la Nutrición. Rev. Neurología 1996; 24(128): ,. Pineda, E, Metodología de la investigación, 2 edición. OPS. México Rex O. Brown. Drug-Nutrient Interaction. Continuing Pharmacy Education. Memphis 2002; Restrepo, J. Impacto Nutriterapéutico de la Interacción Fármaco Nutriente NuevosTiempos; 1998, Medellín; 6(2): Rombeau J, Nutrición Clínica - Alimentación enteral. Editorial Mc Graw-HIll Inter, 3 edición, Capítulos: 1, 2, 7, 13,14, 32. México, Sartoris K, The role of the pharmacist in adult clinical nutrition, New York, 2000 Soler F. Bobis MA., Therapeutics Guidelines for drug administration by feeding tube, Departament of Pharmacy, Hospital Universitario de Girona. Bases para el Desarrollo y aprovechamiento sanitario de la farmacia Hospitalaria; OPS Septiembre Stryer L. Bioquímica 3ra Edición. Barcelona. Reverti Thomson F, Naysmith M, Lindsay A. Managing drug therapy in patients receiving enteral and parenteral nutrition. Hospital Pharmacist2002; 7(6). Villavicencio M, Bioquímica. Universidad Nacional Mayor de San Marcos, Lima, Fondo Editorial UNMSM. Lima.1999 Winter M, Farmacocinética clínica básica, segunda edición, editorial Díaz de Santos, Madrid, Wright D, Pietz S, Decreased in vitro fluoroquinolone concentrations after admixture with an enteral feeding formulation, Journal American Society for Parenteral and Enteral Nutrition 2000; 24(1). immaro D, Acquisition of Clostridium difficile and Clostridium 51

56 ! " # " $ # #! "! % "!! & # &! # " difficile-associated Diarrhea in Hospitalized Patients Receiving Tube Feeding 1998; 129 (12): (revisado: ) Adult Enteral Nutrition (revisado: ) Gunter P, Administering Medications via Feeding Tubes: What Consultant Pharmacist Need to Know,1999. (revisado: ) Lic. Almanzo R. Reacciones, adversos e interacciones a medicamentos. (revisado: ) Aspectos práciticos legales de la nutrición enteral domiciliaria. (revisado: ) Effects ranitidina. Interactions Enteral Feeding: Generation of peroxides and Interactions: Phenytoin and enteral feeding. (revisado: ) Administración de medicamentos por sonda de acceso enteral, Way Huey, Patient Care News, 1997.Traducido por Jaime Valencia para el Pacto Andino Inc. Saint Louis, Missouri, (revisado: ) aneta M. Pronsky, MS. RD, FADA and Sr Jeanne Patricia Crowe, Pharm D, RPh. Mechanisms of Food Medication Interactions.Food Medication Interactions 12 th Edition (revisado: ) Delgado O. Guía de Administración de medicamentos vía oral (revisado: ) Comision de Nutrición Clínica y Dietética HOSPITAL CLÍNICO. Manual de Nutrición Artificial, Granada. (revisado: ) Ferrous sulfate-induced increase in requeriment for thyroxina in a patiente with primary hipothyroidism. (revisado: ) Linda G. Tolstoy, Rph, Drug-induced Gastrointestinal Disorders, Medscape Pharmacotherapy (revisado ) Genua I, Nutrición y Valoración del Estado Nutricional en el Anciano (revisado: ) Overwiew - Identifying Drugs-Nutrients Interactions, (revisado: ) Penrod LE; Allen JB; Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine. Warfarin resistance and enteral feedings: 2 case reports and a supporting in vitro study. Arch Phys Med Rehabil 2001 Sep;82(9): (revisado: ) Interacciones de medicamentos con alimentos. (revisado: ) Interacciones Medicamentosas. (revisado: ) Indicaciones Nutrición Enteral. (revisado: ) 52

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