肠内营养乳剂与乙酰半胱氨酸泡腾片相互作用的临床观察

Clinical Observation of the Interaction between Enteral Nutrition Emulsion and Acetylcysteine Effervescent Tablets

关键词:  肠内营养乳剂  TPF-D  乙酰半胱氨酸泡腾片  配伍禁忌

Key words:  enteral nutrition emulsion  TPF-D  acetylcysteine effervescent tablets  incompatibility

摘要:

摘要：目的：本研究通过总结和分析2例肠内营养乳剂TPF-D与乙酰半胱氨酸泡腾片在临床同时应用后导致食道堵塞的病例信息，并进行2种药物的体外实验初步探讨其相互作用机制及影响因素，旨在报告并证实肠内营养乳剂TPF-D与乙酰半胱氨酸泡腾片存在配伍禁忌，为临床药物应用提供科学依据。方法：通过体外实验模拟临床条件，将TPF-D与不同浓度的乙酰半胱氨酸溶液混合，系统监测混合溶液的物理性状变化及pH值，以评价其相互作用。结果：实验观察到，乙酰半胱氨酸加入TPF-D后导致混合溶液pH值下降，TPF-D溶液随之变粘稠并形成沉淀。当pH值降至3.97时，混合溶液完全凝固。此外，泡腾片剂型的乙酰半胱氨酸与TPF-D混合后溶液的pH值较颗粒剂型更低，更易形成沉淀物。结论：TPF-D与强酸性的乙酰半胱氨酸溶液之间存在明显的配伍禁忌。临床使用时应避免将TPF-D与乙酰半胱氨酸泡腾片等强酸性药物一起使用，以防止食道堵塞等并发症的发生。

Abstract:

ABSTRACT:Purpose: This study summarizes and analyzes the information of 2 cases of enteral nutrition emulsion TPF-D and acetylcysteine effervescent tablets that caused esophageal blockage after clinical application at the same time, and carries out in vitro experiments of 2 drugs to initially explore their interaction mechanism and influencing factors, aiming to report and confirm the incompatibility of enteral nutrition emulsion TPF-D and acetylcysteine effervescent tablets. To provide scientific basis for clinical drug application. Methods: TPF-D was mixed with acetyl cysteine solution of different concentration through in vitro experiment to evaluate the interaction. The physical properties and pH value of the mixture were monitored systematically. Results: It was observed that the pH value of the mixed solution decreased after the addition of acetylcysteine to TPF-D, and the TPF-D solution became viscous and precipitated. When the pH value drops to 3.97, the mixed solution is completely solidified. In addition, the pH value of the solution of acetyl cysteine mixed with TPF-D in effervescent tablets is lower than that of granules, and it is easier to form precipitate.Conclusion: There is an obvious incompatibility between TPF-D and strongly acidic acetylcysteine solution. TPF-D and acetylcysteine effervescent tablets should be avoided in clinical use to prevent complications such as esophageal blockage.