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Nutrition /Pharm Y2S2 - Nutrition Part 2

Pharm Y2S2 - Nutrition Part 2

Nutrition24 CardsCreated about 2 months ago

This deck covers key concepts related to nutrition, including diseases, supplement interactions, feeding methods, and complications associated with enteral and parenteral nutrition.

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What is Wilson's disease?

Build up of copper and excessive copper deposits due to an enzyme deficiency
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Key Terms

Term
Definition
What is Wilson's disease?
Build up of copper and excessive copper deposits due to an enzyme deficiency
What are the problems associated with supplements?
Toxicity / accumulation Supplements are expensive Complacency No control because of legal status Difficult to offer advice as they are not medicin...
What does folic acid interact with?
Methotrexate
What does vitamin C interact with?
Iron
What are the consequences of malnutrition?
Weakness and loss of muscle mass Apathy and depression Reduced immune system Poor wound healing Increased morbidity and mortality
What are the normal feeding aims?
Energy: 25-35 kcal / kg / day Protein: 0.8 - 1.5g / kg / day Fluid: 30 - 35ml / kg / day
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Pharm Y2S2 - Nutrition Part 2
TermDefinition
What is Wilson's disease?
Build up of copper and excessive copper deposits due to an enzyme deficiency
What are the problems associated with supplements?
Toxicity / accumulation Supplements are expensive Complacency No control because of legal status Difficult to offer advice as they are not medicines
What does folic acid interact with?
Methotrexate
What does vitamin C interact with?
Iron
What are the consequences of malnutrition?
Weakness and loss of muscle mass Apathy and depression Reduced immune system Poor wound healing Increased morbidity and mortality
What are the normal feeding aims?
Energy: 25-35 kcal / kg / day Protein: 0.8 - 1.5g / kg / day Fluid: 30 - 35ml / kg / day
What are the methods that can be used to feed patients?
Normla diet Enteral nutrient IV fluids Parenteral nutrition
How is enteral nutrition administered?
Via gastrointestinal tract
What are the benefits of EN?
More physiological Less risk of infection Maintain GIT Gut bacteria translocation Lower cost Easier for home patients Patient ease Calorie control
Which patients would benefit from EN?
Patients with eating / swallowing difficulties Severe intestinal malabsorption Increased nutritional requirements Eating disorders Self neglecting patients
What are the routes of EN administration?
Oral Naso gastric tube Percutaneous endoscopic gastronomy (tube passed through abdominal wall) Percutaneous endoscopic jejunostomy
What are the problems associated with EN?
diarrhoea regurgitation abdominal distention blocked feeding tube problems with the pump taste/acceptability dislocation
How should drugs be administered in EN patients?
Use liquid preparation where possible Give each drug separately Flush with >20ml water before and after Crushed tablets may block tube Not MR or e/c
Which drug directly interact with EN feed?
Ciprofloxacin Albumin antacids Theophylline Phenytoin Penicillamine
When should TPN be used?
When EN is not an option When patient can't take food in orally Digestion / absorption problems Unavailable GIT
What are short term indications for TPN?
waiting for feeding tubes bowel obstruction excisional surgery ICU patients with multi-organ system failure severe pancreatitis pre-term neonates acute intestinal failure
What are long term indications for TPN?
radiation enteritis Crohns disease motility disorders bowel infarction cancer surgery chronic intestinal failure
How is short term TPN administered?
via cannula (Venflon)
How is long term TPN administered?
Peripherally inserted central catheter (PICC) Hickman line Central line : intrajugular, subclavian, femoral
What needs to be monitored when a patient is on TPN?
Clinical history U&Es Glucose Vitamins LFTs FBS Trace elements Fluid balance Weight
What are TPN complications?
air embolism / insertion problems catheter blockage line infections metabolic problems bone disease re-feeding syndrome
What is re-feeding syndrome?
It is characterised by abnormalities in fluid balance, glucose metabolism, vitamin deficiency, hypophosphatemia, hypermagnesaemia and hypokalaemia
How is re-feeding syndrome prevented?
By introducing feed at no more than 50% of the normal requirements. Start at 10kcal / kg / day and increase slowly to meet full needs by 4-7 days
What supplements should be given in re-feeding?
Oral thiamine 200-300mg daily Vitamin B co-strong 1-2 three times daily Multivitamin