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Nutrición Hospitalaria
On-line version ISSN 1699-5198Print version ISSN 0212-1611
Abstract
VAZQUEZ-POLO, Amparo; LOPEZ-BRIZ, Eduardo; POVEDA-ANDRES, José Luis and VAZQUEZ-COSTA, Juan Francisco. Handling of drugs for administration by percutaneous endoscopic gastrostomy in patients with amyotrophic lateral sclerosis and enteral nutrition. Nutr. Hosp. [online]. 2022, vol.39, n.4, pp.716-722. Epub Oct 31, 2022. ISSN 1699-5198. https://dx.doi.org/10.20960/nh.03946.
Introduction:
amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. Its symptoms include dysphagia that may make it necessary to place a percutaneous endoscopic gastrostomy (PEG) for feeding. The administration of drugs by PEG can obstruct it, decrease the effectiveness of treatment, and increase the risk of toxicity by altering the original pharmaceutical form.
Objective:
to describe and analyze the degree of adequacy of the prescription of drugs administered by PEG in patients with ALS and with enteral nutrition (EN).
Material and methods:
the prescription of pharmacological treatment for patients with ALS who were admitted for placement of a PEG was reviewed. The degree of adequacy of the prescribed drugs was analyzed according to criteria of loss of efficacy, toxicity, risk for handler, and compatibility with EN by consulting the available scientific evidence.
Results:
the medical prescriptions of the treatments of 34 patients were reviewed, with a total of 307 medications (median of 9 drugs per patient, range 2-17). Via PEG 267 oral medications (median 8 per patient, range 2-15) were prescribed; 81.65 % were solid forms, and the pharmaceutical form was modified in 43 %, due to the risk of catheter occlusion, toxicity or loss of efficacy, affecting 97 % of the patients.
Conclusions:
patients with ALS and PEG are at risk of presenting safety problems and loss of treatment efficacy related to alteration of the original pharmaceutical form and the interaction with EN.
Keywords : Amyotrophic lateral sclerosis; Enteral nutrition; Enteral tubes; Food-drug interactions; Hazardous drugs; Percutaneous endoscopic gastrostomy.