Enteral feeds Phenytoin

Enteral feed reduces phenytoin absorption by 75%. The pharmacist can recommend the phenytoin to be given as a single dose, if possible. The enteral feeds should be stopped 2 hours prior to and for 2 hours after the dose. The NG tube should be flushed with 20-50 mL of sterile water before feeds and medication. Phenytoin levels must be monitored as this drug has a narrow therapeutic index. [Pg.241]

Reduced bioavailability in the presence of enteral nutrition Possible binding of phenytoin to calcium caseinates or protein hydrolysates in enteral feeding... [Pg.662]

Phenytoin Alcohol Enteral feedings Enhanced metabolism of phenytoin Decreased phenytoin absorption... [Pg.52]

Administering medication with enteral feeds binds phenytoin... [Pg.1919]

Enteral feeds can significantly lower absorption of phenytoin... [Pg.1919]

Hold enteral feeds for minimum of 1 h while administering phenytoin... [Pg.1919]

Enteral feeding formulas Phenytoin Reduced effect of phenytoin Reduced absorption of Phenytoin... [Pg.294]

The interaction of oral phenytoin with enteral feeding formulations has been reviewed (83). Four prospective, randomized, controlled trials in healthy volunteers showed no interaction. However, numerous anecdotal reports and studies have shown dramatic reductions in serum phenytoin concentrations in patients receiving enteral feeding formulations. The authors therefore concluded that this interaction occurs in patients but not in healthy volunteers. [Pg.2818]

Au Yeung SC, Ensom MH. Phenytoin and enteral feedings does evidence support an interaction Ann Pharmacother 2000 34(7-8) 896-905. [Pg.2820]

A number of methods to minimize the interaction between phenytoin and continuous enteral feeding have been suggested, but no consensus exists. Some clinicians choose holding the feeding for 1 to 2 hours before and after phenytoin administration to minimize the interaction. But since this has not been proven effective and may result in suboptimal nutrition, others choose not to interrupt the feeding. [Pg.2631]

Gilbert S, Hatton J, Magnuson B. How to minimize interaction between phenytoin and enteral feedings Two approaches. Nutr Chn Pract 1996 11 28-31. [Pg.2634]

The absorption of phenytoin can be affected by some foods. A very marked reduction in phenytoin absorption has been described when it was given with enteral feeds (e.g. Isocal, OsmoUte), by nasogastric or jejunostomy tubes. [Pg.558]

However, in contrast, a study in 10 healthy subjects found that when Ensure or Vivonex TEN was given every 4 hours for 24 hours, the absorption of a single 400-mg dose of phenytoin was unaffected. Similarly, a single-dose study in healthy subjects found that the bioavailability of phenytoin sodium 400 mg in a capsule formulation (Dilantin Kapseals) was not affected by concurrent enteral feeds (Ensure) ... [Pg.558]

A study in healthy subjects found phenytoin levels were reduced by enteral feeds, but that it was easier to attain therapeutic levels of phenytoin in those also receiving a meat-based formulation (Compleat Modified) rather than a protein hydrolysate formulation (Osmofite). ... [Pg.558]

A study in 20 patients and 5 healthy subjects found that phenytoin absorption was reduced by about 70% when it was given by nasogastric tube with an enteral feed product (Isocat) at a rate of 100 to 125 mL/hour. Other reports describe the same interaction in patients given Ensure Isocaiydi or Os/nofite. " ... [Pg.558]

However, another study in healthy subjects found the absolute bioavailability of phenytoin suspension or phenytoin sodium solution given by nasogastric tube was not affected by an enteral feed product (Isocat) ... [Pg.558]

A woman with a history of seizures had acceptable serum phenytoin levels when phenytoin was given intravenously, but they fell from 19.1 micrograms/mL to less than 2.5 micrograms/mL when a comparable dose of phenytoin suspension was given in the presence of an enteral feed product (levity), given by jqunostomy tube. ... [Pg.558]

Nishimura L Y, Armstrong EP, Plezia PM, lacono RP. Influence of enteral feedings on phenytoin sodium absorption from capsules. Drug IntellClin Pharm (1988) 22, 130-3. [Pg.559]

Guidry JR, Eastwood TF, Curry SC. Phenytoin absorption in volunteers receiving selected enteral feedings. West JMed( 9 9 ) 150, 659-61. [Pg.559]

Weinryb J, Cogen R. Interaction of nasogastric phenytoin and enteral feeding solution. JAm... [Pg.559]

Ozuna J, Friel P. Effect of enteral tube feeding on serum phenytoin levels. J Neurosurg Nurs (1984) 16,289-91. [Pg.559]

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