medications and enteral feedings Flashcards

1
Q

what types of insulin are used to manage blood sugars in enterally fed patients

A

regular/basal insulin and shot acting insulin

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2
Q

what types of medications are preferred for enteral tubes

A

liquid

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3
Q

enterically coated, controlled released and sustained released meds should not be

A

crushed

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4
Q

what medications require stopping the tube feeding pre/post administration

A

Fluoroquinolones: Ciprofloxacin, Levaquin (2 hrs)

Penicillin, Phenytoin, Theophylline

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5
Q

all fluoroquinolones interact with _____ products by causing chelation causing the antibiotic to not work properly

A

multivalent cations (tums, calcium iron, zinc)

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6
Q

the formation of a binding complex with divalent cations causing a decreased of absorption of a drug or nutrient

A

chelation

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7
Q

hypomagnesemia or hyperkalemia following an organ transplant is likely due to these types of antibiotics

A

cyclosporine (penicillin, ceftriaxone)

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8
Q

what medication potentially causes carnitine deficiency

A

Valproic Acid (anti-eleptic)

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9
Q

this medication can provide a significant amount of calories

A

Propofol

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10
Q

Sulfasalazine will increase requirements for____ which is used as an anti inflammatory med for ulcerative colitis/rheumatoid arthritis

A

folic acid

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11
Q

loop diuretics cause urinary losses of

A

calcium/potassium

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12
Q

in the kidney, spironolactone can modulate the excretion of which ions

A

sodium/potassium

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13
Q

iron shouldn’t be provided via jejunal access because

A

an acidic environment is necessary to facilitate absorption and reduction of dietary iron

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14
Q

the drug used in the treatment of tuberculosis forms a complex with pyridoxine is

A

isoniazid

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15
Q

the addition of aluminum hydroxide based medications by lower this element

A

phosphorous

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16
Q

a medication that will decrease folate levels

A

methotrexate

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17
Q

____ used in the treatment of rheumatoid arthritis and leukemia disrupts normal folate and choline metabolism by inhibition of dihydrofolate reductase

A

methorexate

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18
Q

a low albumin may be concerning when providing this medication

A

phenytoin

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19
Q

narcotics may cause

A

constipation

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20
Q

magnesium products such as antibiotics and kayexalate may cause

A

diarrhea

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21
Q

cyproheptadine is a(n)

A

appetite stimulant

22
Q

medications with anorexic effects

A

narcotics, h2 receptor antagonists, anti hypertensive meds

23
Q

digoxin toxicity and PN is associated with

A

hypercalcemia

24
Q

IV____ is contraindicated when a patient is on parenteral nutrition with a digoxin toxicity

A

calcium

25
Q

this diuretic is known for conserving potassium

A

Aldactone

26
Q

grapefruit juice is metabolized by cytochrome P4502a4, the most abundant P450 enzyme and inhibits these types of medications

A

tacrolimus, sirolimus, Depakote, cyclosporine

27
Q

diluting enteral nutrition formulas increases the risk of

A

microbial contamination

28
Q

physical interactions between medications and enteral nutrition formulas can be best avoided by

A

not allowing drugs to mix with EN

29
Q

to avoid mixing EN formulas and medications (if possible) would to be provide medications via

A

sublingual, rectal, intramuscular, subcutahnous, IV

30
Q

avoid ___ beverages in the feeding tube to avoid degradation of the formula including

A

acidic

cranberry juice, carbonated beverages

31
Q

enteric coated medications require ___ for digestion/absorption so cannot be given a ____ tube

A

acidic stomach pH

jejunal tube

32
Q

if an enteric coated medication must be given in the jejunum be sure to mix it with ____ and wait 34-45 minutes as can occlude the tube

A

bicarbonate

33
Q

if a medication is appropriate to crush to be given via an enteral tube it should be

A

fine powder and mixed with warm water

34
Q

_____ medications should not be crushed as it will alter their pharmacodynamics and cause inadequacy or toxicity of the medication

A

extended release

35
Q

____ medications are high in osmolarity and can cause diarrhea

A

sorbitol/liquid medications

36
Q

what methods are available to limit medication interactions with EN

A

use immediate release medications
avoid enteric coated or sublingual
use proper tube flushing

37
Q

____ studies the time course for drug absorption, distribution, metabolism and execution of medications

A

pharmacokinetics

38
Q

_____ occurs during light exposure to medications which affects mostly opaque formulas including ILE’s and EN formulas

A

photo-degradation

39
Q

______ is the interaction between the amino group of amino acids and carbonyl portion of carbohydrates causing browning

A

maillard reaction

40
Q

these medications will slow down gastric emptying and GI motility

A

anticholinergic agens, narcotics and opioids

41
Q

holding EN administration for 1-2 hours every 6-8 hours for medication administration is likely to result in

A

inadequate nutrition and deterioration of nutrition status unless a volume based protocol is used

42
Q

what is recommended to produce the most consistent results when administering phenytoin during enteral nutrition administration

A

hold tube feeding for at least 1 hour and possibly 2 hours pre and post administration

43
Q

carbamazepine slows gastric emptying and EN infusion should be held ____ hours pre/post administration

A

2 hours

44
Q

Fluoroquinolones (levaquin, ciprofloxacin) are a class of antibiotics that should be he’d for ___ hours pre, ___ hours post TF administration as they bond with divalent/trivalent cations such as iron and calcium

A

1 hour pre

2 hours post

45
Q

____ controls the legal definition of dietary supplements under the FDA Federal Food, Drug and Cosmetic ACT stating supplements must be labeled as a dietary supplement

A

DSHEA

46
Q

a product that is not represented for use as a conventional food or sole item of a meal/diet is called

A

supplement

47
Q

a group of diverse medical and healthcare systems, practices and products that are not generally considered part of conventional medicine

A

complimentary medicine

48
Q

a ____ food is food that moves beyond the necessity to provide additional health benefits that may reduce disease risk and or promote optimal healthy

A

function food

49
Q

a ______ claim is a statement that a product is not intended to prevent or cure a disease

A

structure/function claim

50
Q

an explicit or implied characterization of a relationship between a substance and.a disease or a health related condition

A

health claim

51
Q

“calcium may reduce the risk of osteoporosis” is known as a ___ claim

A

health claim