PARENTERAL NUTRITION FOR PHARMACISTS

Question 1

When to Use Parenteral Nutrition (PN)

Answer 1

Parenteral nutrition (PN) is only for patients who cannot use their digestive system (GI tract).

Malnourished patients → PN is needed if they cannot eat or digest food properly.
Well-nourished, stable patients → Start PN only if GI issues last more than 7 days.
At-risk patients (poor nutrition, low intake) → Start PN within 3-5 days to prevent further decline.
Critically ill patients without malnutrition → PN can increase infection risk, so it’s used carefully.
If PN is delayed for 14 days → It has been linked to better survival and shorter hospital stays.

Question 2

Who Are Nutritionally At-Risk Patients?

Answer 2

A patient is considered nutritionally at risk if they have:

✅ Significant weight loss

10% of usual body weight in 6 months or
5% of usual body weight in 1 month or
Unintentional loss of 10 pounds in 6 months
✅ Low body weight → BMI less than 18.5 kg/m²

✅ High energy needs → Due to illness, injury, or stress on the body

✅ Diet changes → Restricted diets or irregular meal schedules

✅ Not eating enough → No food or nutrition for more than 7 days

These patients may need special nutrition support to prevent malnutrition and complications.

Question 3

Indications for TPN

Answer 3

Cancer
AIDS
Crohn’s disease
Surgical removal of the intestines
Severe diarrhea
Hyperemesis gravidarum
Premature neonate
Coma