Effectively Delivery Esomeprazole Tablet By Nasogastric Administration

Esomeprazole錠劑經管灌給藥之有效劑量探討

葉爵榮(Jue-Zong Yeh) ； 金秦瑩(Chin-Ying Chin) ； 葉明功(Ming-Kung Yeh)

《臺灣臨床藥學雜誌》 20卷2期 (2012/06) Pp. 127-139

摘要

研究方法：我們設計了5種臨床常見esomeprazole錠通過鼻胃管投藥條件，包含（鼻胃管材料、稀釋液的容量、鼻胃管沖洗次數、連續管灌時間和合併營養配方灌食等影響因素），經收集灌食液、過濾，並且透過高壓液相層析儀分析樣品，以了解esomeprazole經管灌投藥是否會造成有效劑量損失。研究結果：Esomeprazole藥錠以25或50mL的蒸餾水崩散成懸浮液，並且透過注射器注入16號鼻胃管，再另外以25或50mL蒸餾水沖洗管壁，結果顯示在第一次的沖洗後，藥物的通過量有明顯的差異（p＜0.05）。Esomeprazole管灌通過量累積百分比顯著受到鼻胃管材質、稀釋液容量、管壁沖洗容量和營養灌食配方影響，但在藥品管灌後的沖洗頻率、超過七天以上的連續管灌結果沒有顯著差異。經不同材質之16號鼻胃管執行Isocal營養配方灌食後，投與esomeprazole水溶液（esomeprazole錠劑40mg溶解於25mL蒸餾水），收集第一天管灌後，直接通過16號鼻胃管之殘餘含藥溶液之體積，經HPLC分析出殘餘藥量百分比於使用polyvinyl chloride管為38.3％，相對polyurethane管為43.0％。結論：Esomeprazole錠劑的管灌劑量，在通過鼻胃管時易受到餵食管材質、管灌水量及營養配方之管理措施影響，將會影響藥療品質和醫療保健的成本效益。我們建議需管灌時，esomeprazole錠劑以50mL蒸餾水崩散成懸浮液，並使用50mL的蒸餾水沖洗管壁，可增加管灌通過率，減少esomeprazole劑量損失。

關鍵字

esomeprazole ； 鼻胃管 ； 管材質 ； 營養 ； 鼻胃管投藥

並列摘要

Purpose: To determine esomeprazole delivery efficiency during transit through the nasogastric tubes. Methods: We assessed the influence of 5 variables (the type of 16-French nasogastric tube materials, dilution solvent volume, administration pattern, treatment duration time, and delivery nutrition factor) on esomeprazole tablets delivered via nasogastric tube to determine whether esomeprazole was lost during transit through the tube. Samples were filtered and analyzed by HPLC. Results: Esomeprazole pellets were suspended in 25 or 50 mL water and administered through a syringe into a 16-French nasogastric tube, and when rinsed with an additional 25 or 50 mL of distilled water, a significant difference (p ＜ 0.05) in results was obtained at the first washing. The cumulated percentage of esomeprazole was significantly affected by tube material, dilution solvent volume, water rinsing volume, and nutrition administration, but no significant difference existed between the frequency of water rinsing or the tube incubation duration after 7 days. When esomeprazole was administered after Isocal nutrition, the percentage of esomeprazole collected was directly related to the type of 16- French nasogastric tube (polyvinyl chloride, 38.3% vs. polyurethane, 43.0%), as analyzed in 25 mL water at day 1. Conclusion: The efficiency of esomeprazole tablets when delivered via nasogastric tubes is affected by the administration process, which may affect the quality of pharmacotherapy and the cost-effectiveness of healthcare. We suggested that esomeprazole tablets required the 50 mL of distilled water for the first injection to avoid loss of esomeprazole.

並列關鍵字

esomeprazole ； nasogastric tube ； tube material ； nutrition ； nasogastric administration