Artificial nutrition

A 29-year-old woman took citalopram (40 mg/day) while breast feeding her 5-week-old daughter. The maternal citalopram concentrations were 99 ng/ml in the serum and 205 ng/ml in the breast milk. The serum concentration in the infant was 13 ng/ml, and the child s sleep was fitful and disturbed. The dosage of citalopram was reduced to 20 mg/day and the two feeds after each daily dose were replaced by artificial nutrition. One week later the infant was sleeping normally, and the serum citalopram concentrations in mother and infant had fallen to 35 ng/ml and 2 ng/ml, respectively. 

Elia M. Changing concepts of nutrient requirements in disease implications for artificial nutritional support. Lancet 1995 345(8960) 1279-84. 

Increasing the energy intake in patients with AKI from 30 kcal/kg/ day to 40 kcal/kg/ day did not improve estimated nitrogen balance and was associated with more artificial nutrition-related side-effects... 

Elia M. Metabolic response to starvation, injury and sepsis. In Payne-James J, Grimble G, Silk D, eds. Artificial nutrition support in clinical practice. London GMM, 2001 1-24. 

Type of document Title, publication year, reference Drug selection Drug information Pharmaco- kinetics Artificial nutrition Clinical trials Drug use Pharmaco- vigilance Other... 

Policy document SEFH recommendations on artificial nutrition (Sociedad Espanola de Farmacia Hospitalaria, 1997).ti9]... 

The SEFH considers artificial nutrition to be multidisciplinary in range and scope and, therefore, recom-... 

In the SEFH s view, the preparation and dispensation of artificial nutrition is not the pharmacy services only activity, as they can also perform prescription and clinical monitoring. This already occurs at a number of Spanish hospitals the pharmacist prescribes and performs daily checkups on patients being fed artificially. 

This chapter describes the activities performed by the pharmacist as a member of the nutritional support team, which involve a range of tasks from indications, assessment of nutritional state, and the preparation of artificial nutrition for adults and children to concepts on basic dietetics and mother-infant nutrition. Drug-nutrient interaction analysis is another duty. 

Comision de Nutricion Artificial (Artificial Nutrition Commission)... 

TPN should, as its name suggests, provide complete artificial nutrition. An appropriate volume of fluid w ill contain a source of calorics, amino acids, vitamins and trace elements (Fig. 2). The caloric... 

For pharmaceutical purposes 2000-3000 tonnes of amino acids are required annually worldwide. More than half of this amount ends up in infusion solutions for artificial nutrition. Many amino acid derivatives are pharmacologically important acetylcysteine is mucolytic, (L)-DOPA an active agent to combat Parkinson s disease, and Oxitriptan ((S)-5-hydroxytryptophan) is an antidepressant. Specifically substituted, (D)-configured, a- and /3-amino acids find widespread application as building blocks for drug synthesis. 

Acidic and basic amino acids, like glutaric acid, aspartic acid and lysine, are also isolated from protein hydrolysates for artificial nutrition. The fractions are filtered off under sterile conditions and further purified by crystallisation. Since the BSE crisis, the supply with amino acids has come under scrutiny manufacturers had to assure regulators and customers likewise, that their starting material does not originate from cattle. Mostly used are poultry feathers and pork gelatine. [62]... 

Artificial Nutrition of Nursing Infants. II. Fat Analyses in the Blood and Subcutaneous Tissue by Gas Chromatography... 

Biological, non-parasitic production of ergot alkaloids is carried out by saprophytic cultivation of production strains of different species of the genus Claviceps. The saprophytic cultivations of Claviceps spp. were experimentally performed as early as in the last century (Bove, 1970). Mycelial saprophytic cultures in nutrient media were reported since the 1920s (Bonns, 1922 McCrea, 1931 Schweizer, 1941 De Tempe, 1945). These experiments provided the basis of cultivation of the fungi Claviceps under artificial nutritional conditions but did not yet serve for alkaloid production or were not reproducible (McCrea, 1933). 

Refeeding syndrome is a series of metabolic complications linked to artificial nutritional support in patients who are severely malnourished, with conditions such as kwashiorkor, chronic malnutrition, or anorexia nervosa. This study shows that even hypocaloric feeding should be considered a susceptibility factor for the refeeding syndrome. 

Wengler A, Micklewright A, Heburtume Y, et al. ESPEN-home artificial nutrition working group. Monitoring of patients on home parenteral nutrition (HPN) in Europe a questionnaire based study on monitoring practice in 42 centers. Clin Nutr 2006 25(4) 693-700. 

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