Armin Eisazaei-Pharm D

Al Ameen College of pharmacy

  supplies all daily nutritional requirements.
 feeding a person intravenously, bypassing the
usual process of eating and digestion.
 The person receives nutritional formulae that
contain nutrients such as glucose, amino
acids, lipids and added vitamins and dietary
minerals .
 TPN can be used in the hospital or at home.
 (TPN) is provided when the gastrointestinal tract is nonfunctional
because of an interruption in it or because its absorptive capacity is
impaired

 TPN may be the only feasible option for providing nutrition to

patients who do not have a functioning gastrointestinal tract or who
have disorders requiring complete bowel rest,

 including bowel obstruction, short bowel

syndrome,Gastroschisis, prolonged diarrhea regardless of its
cause, high-output fistula very severe Crohn's disease or ulcerative
colitis
 Parenteral nutrition is administered through a needle or
catheter.
 This is placed in a large vein that goes to the heart. It is
usually used for 10 to 12 hours a day, five to seven times
a week. Most intravenous feedings are completed at
home
 The most common side effects of parenteral
nutrition are mouth sores, poor night vision, and
skin changes
 changes in heartbeat
 confusion
 increased urination
 vomiting
 stomach pain
 tingling in the hands or feet
 swelling of the hands, feet, or legs
 Acquisition and Delivery
Purchase and/or preparation (!)
Distribution
 Drug use and administration

Recommendations and guidelines

(dosages, interactions, i.v. administration...)
 Control and Review

Product quality
Handling (correctness,legality, safety)
Analysis of indications, outcome ,Cost
 Stock management, Waste
 The most common risk of using parenteral
nutrition is developing catheter infection. Other
risks include blood clots, liver disease, and bone
disease.
It is essential to maintain clean tubing, needles,
catheters, and other equipment to minimize these
risks.
 TPN requires water (30 to 40 mL/kg/day),
 energy (30 to 45 kcal/kg/day, depending on energy
expenditure),
 amino acids (1.0 to 2.0 g/kg/day, depending on the
degree of catabolism),
 essential fatty acids,
 vitamins, and
 minerals
 Normally, 2 L/day of the standard solution is needed
 Solutions may be modified based on laboratory results,
underlying disorders…
 Calculate requirements for water (30 to 40 mL/kg/day),
energy (30 to 45 kcal/kg/day, depending on energy
expenditure), amino acids (1.0 to 2.0 g/kg/day, depending
on the degree of catabolism), essential fatty acids, vitamins,
and minerals
Plasma glucose should be monitored every 6 h until
patients and glucose levels become stable. Fluid
intake and output should be monitored continuously.
When patients become stable, blood tests can be
done much less often.