TOTAL PARENTERAL NUTRITION

Armin Eisazaei-Pharm DAl Ameen College of pharmacy

TOTAL PARENTERAL NUTRITION (TPN)

supplies all daily nutritional requirements. feeding a person intravenously, bypassing

the usual process of eating and digestion. The person receives nutritional formulae that

contain nutrients such as glucose, amino acids, lipids and added vitamins and dietary

minerals . TPN can be used in the hospital or at home.

INDICATIONS

 (TPN) is provided when the gastrointestinal tract is nonfunctional because of an interruption in it or because its absorptive capacity is impaired

TPN may be the only feasible option for providing nutrition to patients who do not have a functioning gastrointestinal tract or who have disorders requiring complete bowel rest,

including bowel obstruction, short bowel syndrome,Gastroschisis, prolonged diarrhea regardless of its cause, high-output  fistula  very severe Crohn's disease or ulcerative colitis

(TPN)ADMINSTRATION

Parenteral nutrition is administered through a needle or catheter.

This is placed in a large vein that goes to the heart. It is usually used for 10 to 12 hours a day, five to seven times a week. Most intravenous feedings are completed at home

SIDE EFFECTS

The most common side effects of parenteral nutrition are mouth sores, poor night vision, and skin changes

changes in heartbeat confusion increased urination vomiting stomach pain tingling in the hands or feet swelling of the hands, feet, or legs

PHARMACIST TASKS Acquisition and DeliveryPurchase and/or preparation (!)

Distribution Drug use and administrationRecommendations and guidelines

(dosages, interactions, i.v. administration...) Control and ReviewProduct quality

Handling (correctness,legality, safety)

Analysis of indications, outcome ,Cost Stock management, Waste

PRECAUTIONThe most common risk of using parenteral nutrition is developing catheter infection.

Other risks include blood clots, liver disease, and bone disease.

It is essential to maintain clean tubing, needles, catheters, and other equipment to

minimize these risks.

NUTRITIONAL CONTENT TPN requires water (30 to 40 mL/kg/day), energy (30 to 45 kcal/kg/day, depending on

energy expenditure), amino acids (1.0 to 2.0 g/kg/day, depending

on the degree of catabolism), essential fatty acids, vitamins, and minerals 

Normally, 2 L/day of the standard solution is needed Solutions may be modified based on laboratory

results, underlying disorders… Calculate requirements for water (30 to 40

mL/kg/day), energy (30 to 45 kcal/kg/day, depending on energy expenditure), amino acids (1.0 to 2.0 g/kg/day, depending on the degree of catabolism), essential fatty acids, vitamins, and minerals

MONITORINGPlasma glucose should be monitored every 6 h until patients and glucose levels become stable. Fluid intake and output should be monitored continuously. When patients become stable, blood tests can be done much less often.

THANK YOU.,