Basic Civil Engineering first year Notes- Chapter 4 Building.pptx
14ab1t0001 tpn
1. TOTAL PARENTERAL NUTRITION
Submitted by Under the guidance of
Anche Sravani Dr.G. Ramesh
14AB1T0001 Department of Pharmacy Practice
Pharm.D IV Year
Vignan Pharmacy College, Vadlamudi 1
2. CONTENTS
INTRODUCTION AND DEFINITION
TYPES OF PARENTERAL NUTRETION
REQUIREMENTS OF TPN
MANUFACTURING OF TPN
ADMINISTRATION
LABELLING
PHARMACEUTICAL USES
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3. INTRODUCTION: -
Total parenteral nutrition (TPN) is a method that bypasses
the gastrointestinal tract, because of its absorptive capacity
is impaired. Fluids are given into a vein to provide most of
the nutrients the body needs.
DEFINITION: -
Total parenteral nutrition (TPN) is intravenous
administration of calories & other nutrients in sufficient
quantities to achieve tissue synthesis & anabolism
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4. TYPES OF PARENTERAL NUTRITION:-
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CENTRAL PARENTERAL NUTRITION –
• It is often called as total parenteral nutrition (TPN); delivered into
central vein. It includes lipids, vitamins, minerals, amino acids (>5%),
dextrose (>20%), & trace elements.
PERIPHERAL PARENTERAL NUTRITION –
• PPN is delivered into a smaller or peripheral vein. Total kcal limited by
concentration & ratio to volume being administered .
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5. REQUIREMENTS OF TPN
Requirements of TPN include
Carbohydrates
Lipids(fat)
Amino acids
Electrolytes
Trace elements and
Fluids
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6. CARBOHYDRATES: -
Eg- DEXTROSE
Carbohydrates is the main source of energy. The
monohydrate form of glucose is the primary source of carbohydrates
used in TPN. Others carbohydrates source such as fructose, galactose
& sorbitol should not be used as energy sources in TPN.
LIPIDS (FAT): -
This is the primary source of essential fatty acid (linoleic acid) in
TPN. Linoleic acid is useful as precursors of prostaglandins & in the
synthesis of other fatty acids which are essential for cell membrane
integrity.
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7. ELECTROLYTES: -
Sodium(Na) – 100 to 200 mEq;
Potassium(K) – 80 to 120 mEq;
Magnesium(mg) – 8 to 16 mEq;
Calcium(Ca) – 5 to 10 mEq;
Chloride(Cl) – 100 to 200 mEq;
VITAMINS: -
The daily requirement of both water soluble & fat soluble vitamins
should be added to TPN formulation. These vitamins are required for
the metabolism of carbohydrates, proteins, fats. Fat soluble vitamins
are A, D, E & K. Water soluble vitamins are B1, B2, B3, B5, B6, B7, B9,
B12, & C.
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9. LABELLING OF SOLUTIONS:
The prepared solution’s label should contain the following:
Name of the drug
Strength
Instructions for use.
Expiration date
The prepared solution is good for 24 hours (stability) and it is to
be kept in the refrigerator until the time of use.
TPN solutions should not be mixed with other intravenous
solutions (separate lines should be used), unless it is discussed
with the pharmacist to determine compatibility.
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10. TPN ADMINISTRATION
Nutritional requirements differ based on metabolism and age groups
(neonates, pediatrics, adults).
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Age groups Age
Neonates Birth-1month
Infants 1month-1year
Early childhood 1year-6years
Late childhood 6-12years
Adolescent 13-17years
Adult Above 17years
11. PHARMACEUTICAL USES
• Inability to absorb nutrients via the gastrointestinal tract.
• Cancer – antineoplastic therapy, radiation therapy, bone marrow
transplantation.
• Moderate to serve pancreatitis when adequate enteral intake is not
expected for 5 to 7 days.
• Serve malnutrition with a temporary nonfunctional gastrointestinal
tract.
• Critical care situations.
• Organ failures – liver, renal, respiratory.
• Hyper emesis.
• Eating disorders.
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12. S.no Parameter Normal range
1 Total kilo calorie / day 25-30 k.cal/kg
2 Protein requirement 0.8-2 gm/kg
3 Dextrose 3-5 mg/kg/min
4 Fat emulsion 10,20,30 %
5 Fluid 2.5 lit-3.5 lit
6 Sodium 1-2 m.eq/kg
7 Potassium 1-2 m.eq/kg
8 Calcium 10-15 m.eq/kg
9 Magnesium 8-20 m.eq
10 Phosphorous 20-40 m.moles
11 Trace element 3-5ml
12 Vitamins 10ml
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13. REFERENCES
N. Narayanan & S. Balasubramanian; Hospital & Clinical pharmacy;
2nd Edition; pg.no:-106 to 113.
D. Sudheer Kumar, J. Krishnaveni, P. Manjula; Fundamentals of
clinical pharmacy practice; 1st Edition (reprint); pg.no:- 280 to 309.
K. Ravi Shankar & G.V.N. Kiranmayi; Clinical pharmacy &
pharmacotherapeutics; 1st Edition; pg.no:- 58 to 67.
https://www.moh.gov.sa/depts/Pharmacy/Documents/Total%20Parent
eral%20Nutrition%20(TPN).pdf
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