Nasogastric feeds

A.L. Clark-Schmidt, et al., Loss of carbamazepine suspension through nasogastric feeding tubes. Am. J. Hosp. Pharmacol. 47 2034-2037, 1990. 

Figure 20-2. Photograph of D.E.C. at 5 months. Note nasogastric feeding tube and...

Dehydration should be corrected with intravenous fluid replacement, and nasogastric feeding should be instituted in those with unsatisfactory swallow. 

There is a risk of gastroesophageal reflux during nasogastric feeding, especially in mechanically ventilated and sedated patients (1). 

Bauer LA. Interference of oral phenytoin absorption by continuous nasogastric feedings. Neurology 1982 32 570-572. 

Nasogastric feeding impairs absorption to a highly variable degree. 

Worden JP, Wood CA, Workman CH. Phenytoin and nasogastric feedings. Neurology ( 9 4)... 

A number of reports describe the development of hard putty-like or creamy precipitations and encrustations that have blocked the oesophagus or stomach of patients given sucralfate with enteral feeds (Ensure Pbis Fresubin plus F or Osmolit ). Another patient developed this precipitate when treated with Isocal and sucralfate with aluminium/magnesium hydroxide. Similarly, a patient receiving Pubnocare nasogastric feed, sucralfate and aluminium hydroxide gel also developed an oesophageal be-zoar, which was analysed and found to contain components of both the drugs and the enteral feed. ... 

Data from the French Pharmacovigilance system database found 16 adults and 5 newborn babies who developed bezoars while taking sucralfate, and identified nasogastric feeding as a risk factor. ... 

Gal P, La3Tson R. Interference with oral theophylline absorption by continuous nasogastric feedings. Ther Drug Monit(y9ZC) 8, 421-3. 

Symptomatic MSUD in a neonate is a medical emergency and requires the immediate initiation of nutrition support to reverse catabolism. Nonprotein calories are provided by peripheral or central line access. A source of BCAA-free amino acids is needed as soon as treatment begins. Nasogastric feedings of an MSUD medical food can be provided, or if gastrointestinal administration is not tolerated, BCAA-free parenteral solutions are available (Coram Specialty Infusion Services, Denver, Colorado). 

Clark-Schmidt, A.L. Garnett, W.R. Lowe, D.R. Karnes, H.T. Loss of carbamazepine suspension throu nasogastric feeding tubes. Am.J.Hosp.Pharm., 1990, 47, 2034-2037... 

There are additional requirements for an oral liquid administered via a nasogastric feeding tube ... 

In the request for a pharmacy preparation, the physician often prescribes the administration route. Pharmacists have to critically evaluate whether the proposed route is appropriate to reach the desired bioavailability. For example, conventional oral medications may not be suitable for patients with a nasogastric feeding tube, children, or nauseous patients and alternative routes such as parenteral, rectal, or nasal have to be considered (see also Sect. 37.6.3). When adapting a dosage form or administration route to special needs of a patient, the pharmacist is required to consider safety aspects. It is important to recognise that an active substance approved for oral administration may never have... 

Venezia RA, Agresta MD, Hanley EM, Urquhart K, Schoonmaker D. Nosocomial legionellosis associated with aspiration of nasogastric feedings diluted in tap water. Infect Control Hosp Epidemiol 1994 15 529-533. 

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