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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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이경화 (분당서울대학교병원 약제부) 허은정 (분당서울대학교병원 약제부) 김윤희 (분당서울대학교병원) 이정화 (분당서울대학교병원 약제부) 이은숙 (분당서울대학교병원 약제부) 김은경 (서울대학교 약학대학) 송인애 (분당서울대학교병원 마취통증의학과)
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한국병원약사회 병원약사회지 병원약사회지 제38권 제1호
발행연도
2021.1
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41 - 51 (11page)

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Background : Patients in surgical intensive care unit (SICU) commonly receive numerous intravenous drugs and are supported by parenteral nutrition. Thus, patients are often exposed to drug-nutrient interactions and incompatibilities. Compatibility issues with parenteral administrations are crucial for practitioners as it could impact clinical outcomes. The purpose of this study was to evaluate the appropriateness of drug administration by investigating drug-nutrient interactions and compatibility and to assess drug users’ recognition and experiences related with ICU pharmacist services. Methods : A retrospective evaluation of drugs and nutrients in all prescriptions of patients admitted to the SICU during June 2017 was performed using electronic medical records. Then, in from September to October 2017, the drug administration routes were checked in patients who received total parenteral nutrition (TPN) in the ICU and drug adjustments were performed if the combination was inappropriate. Questionnaires were distributed to SICU nurses responsible for administering drugs for one week to assess the recognition and required pharmacy service regarding drug-nutrient compatibility. Results : In this study, 247 intravenous drug-nutrient interactions were identified from 18,350 combinations between drugs and nutrients. Fifteen interactions were recorded as “consideration of therapeutic correction” by the Lexicomp online® standard and all were interactions between calcium and ceftriaxone. The drug route study revealed 18 incompatibilities in intravenous drug-nutritional combinations, of which were ‘no concomitant data’ on the basis of the Lexicomp online®. In the nurses’ questionnaire conducted after the pharmacists’ interventions, 86.7% were aware of Y-site incompatible drugs and 16.7% experienced witnessing sedimentation or foreign materials. The required clinical pharmacy service was easy access to acquire information regarding compatibility. Conclusion : Findings from our study show that pharmacists’ interventions were necessary to determine drug modification of drugs or routes of drug administration. Additionally, the questionnaire confirmed the need for development of information access services regarding drug administration.
#Surgical intensive care unit #Drug-nutrient interaction #Drug-nutrient compatibility

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참고문헌 (21)

참고문헌 신청
Moyen E / 2008 / Clinical review : Medication errors in critical care : review / Critical Care 12(2):208~215 google schola Jeejeebhoy / 2012 / Parenteral nutrition in the intensive care unit / Nutrition Reviews 70(11):623~630 google schola Tatiane Heldt / 2013 / Drug-nutrient interactions in the intensive care unit : literature review and current recommendations / Revista Brasileira de terapia intensive 25(2):162~167 google schola Laura M. Fox / 2013 / Physical compatibility of various drugs with neonatal total parenteral nutrient solution during simulated Y-site administration / American Journal of Health-System Pharmacy 70(6):520~524 google schola Joseph I. Boullata / 2012 / Drug–Nutrient Interactions : A Broad View with Implications for Practice / Journal of the Academy of Nutrition and Dietetics 112(4):506~517 google schola

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