Enteral and parenteral nutrition considerations in pediatric patients
compounding; enteral; neonatal; nutrition; parenteral; pediatric; stability
October 2019 Update
PURPOSE: Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. SUMMARY: The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. CONCLUSION: The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.
Cober Mary Petrea; Gura Kathleen M
American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/ajhp/zxz174" target="_blank" rel="noreferrer noopener">10.1093/ajhp/zxz174</a>
Olfactory bulb norepinephrine depletion abolishes vasopressin and oxytocin preservation of social recognition responses in rats.
*Social Behavior; Animals; Arginine Vasopressin/administration & dosage/*pharmacology; Infusions; Male; Norepinephrine/*physiology; Olfactory Bulb/drug effects/*physiology; Oxidopamine/administration & dosage/pharmacology; Oxytocin/administration & dosage/*pharmacology; Parenteral; Rats; Time Factors; Wistar
Male rats were implanted bilaterally with cannulae directed at the olfactory bulbs and infused with either vehicle or 6-OHDA to selectively deplete norepinephrine concentrations at this site. At 5-7 days following this treatment, these animals received a bilateral infusion of either arginine vasopressin (AVP) or oxytocin (OXT) through these same guide cannulae and were then tested for their capacity to maintain social recognition responses. Neither infusion of AVP nor OXT were able to preserve recognition responses in the animals treated with
Dluzen D E; Muraoka S; Landgraf R
Neuroscience letters
1998
1998-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0304-3940(98)00691-0" target="_blank" rel="noreferrer noopener">10.1016/s0304-3940(98)00691-0</a>
Castration reduces olfactory bulb norepinephrine transporter function as indicated by responses to noradrenergic uptake blockers.
*Symporters; Adrenergic Uptake Inhibitors/*pharmacology; Animals; Atomoxetine Hydrochloride; Carrier Proteins/*metabolism; Infusions; Isotonic Solutions; Male; Norepinephrine Plasma Membrane Transport Proteins; Norepinephrine/*metabolism; Olfactory Bulb/*metabolism; Orchiectomy; Parenteral; Propylamines/pharmacology; Rats; Sprague-Dawley; Testis/*physiology; Thiophenes/pharmacology
It has been demonstrated that castration alters the functioning of the olfactory bulb (OB)-norepinephrine (NE) system. In the present experiment, we examined one of the mechanisms by which castration modulates the OB-NE system by comparing NE uptake activity between intact and castrated male rats as studied using an in vitro superfusion technique. To accomplish this goal, NE output from the OB of intact and castrated male rats in response to infusion with two different drugs which alter NE uptake functions, tomoxetine and talsupram, were tested. Overall, NE outputs in response to tomoxetine were significantly higher in the castrated than in intact rats and both groups were significantly greater than non-infused controls. For the talsupram infusion group, NE outputs from the castrated, but not intact rats, were significantly greater than controls. No statistically significant differences were detected between the castrated and intact rats. These results demonstrate that castration alters the NE uptake activities in response to these noradrenergic uptake blockers and suggest that one mechanism by which castration alters OB-NE functioning is through reducing the uptake activity of NE within the OB. Such findings have important implications for olfactory-based learning and memory/recognition processes which are believed to involve the OB-NE system and are altered following castration.
Shang Y; Dluzen D E
Brain research
1998
1998-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0006-8993(97)01101-3" target="_blank" rel="noreferrer noopener">10.1016/s0006-8993(97)01101-3</a>
The effect of intermittent-release intraperitoneal chemotherapy on wound healing.
Animals; Antineoplastic Agents/administration & dosage/*pharmacology; Carboplatin/administration & dosage/*pharmacology; Infusions; Laparotomy; Male; Paclitaxel/administration & dosage/*pharmacology; Parenteral; Rats; Sprague-Dawley; Tissue Adhesions/chemically induced; Wound Healing/*drug effects
OBJECTIVE: Our purpose was to study the effect on wound healing when intraperitoneal chemotherapy was instilled on a daily basis. STUDY DESIGN: Intraperitoneal carboplatin, Taxol, or saline solution was instilled daily into 70 rats after they underwent laparotomy. The animals were killed and analyzed for adhesions. An area measuring 5 x 5 cm including the incision was also harvested for biomechanical testing. The wound thickness was measured, and the Shore Western Materials Testing System (Monrovia, Calif.) was used to test the force required to break the wound, the stress, and the stiffness. RESULTS: Groups of 10 rats received saline solution control, carboplatin 6 mg/kg, 7 mg/kg, 8 mg/kg, or Taxol 2.5 mg/kg, 3.0 mg/kg, or 3.5 mg/kg. The total dose was divided into seven equal amounts, administered daily. No significant adhesions developed in any of the animals. The carboplatin group experienced no significant decrease in wound thickness whereas the higher-dose Taxol group had a significant decrease in thickness from 1.06 mm to 0.72 mm (p = 0.02). The wound-breaking strength (force) also decreased for the highest-dose Taxol group from 710 gm to 411 gm (p = 0.02). The wound stiffness was also decreased from 69 gm/mm to 46 gm/mm (p = 0.01). The other measured parameters for both the Taxol and carboplatin groups were not significantly decreased when compared with those of controls. CONCLUSION: The immediate instillation of divided daily carboplatin did not influence wound strength whereas the use of Taxol on a similar schedule significantly decreased wound strength.
Hopkins M P; von Gruenigen V E; Holda S; Weber B
American journal of obstetrics and gynecology
1997
1997-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0002-9378(97)70606-9" target="_blank" rel="noreferrer noopener">10.1016/s0002-9378(97)70606-9</a>