Phenytoin and enteral feeds Dilantin levels with continuous delivery of enteral feedings a pilot study. Faraji b, yu pp serum phenytoin levels of patients on gastrostomy tube feeding.   vegetables, cheeses and certain anticonvulsants agents phenytoin dilantin serum phenytoin concentrations may be decreased by continuous enteral feeds. Possible reasons for the impaired absorption include phenytoin adhering to the enteral tube itself the interaction of oral phenytoin with enteral feeding formulations has been reviewed 83.

  this article discusses types of enteral feeding tubes, methods, and formulas. Phenytoin oral suspension 30mg5ml 90mg drugs should only be administered via finebore enteral feeding tubes as a last resort and other routes of administration should be  clinically significant interactions include, phenytoin, digoxin, ciprofloxacin and rifampicin. Tanaffos 2008735962. Received enteral feeding preparations andor related nutritional supplements have lower than expected phenytoin plasma levels. Comparative effects of an elemental and a complex enteral feeding formulation on the absorption of phenytoin suspension.   urinary excretion of phenytoin and its metabolites occurs partly with glomerular filtration but more importantly by tubular secretion.   it is therefore suggested that phenytoin not be administered concomitantly with an enteral feeding preparation. Enteral feeding containing protein, carbohydrate, fat, water etc. For example, it is important to stop the enteral feed for two hours before phenytoin is administered via an enteral feeding tube and for two hours afterwards. Separate liquid nutritional products at least 1 hour before and 1 hour after your phenytoin considerations for drugenteral tube feeding interaction. Vmax was higher in group 2 than in group 1 medians, 709versus 394 mgday andkm smaller medians, 2. Arah phys med rehabil 1988 699682684. Vmax was higher in group 2 than in group 1 medians, 709versus 394 mgday andkm smaller medians, 2. Faraji b, yu pp serum phenytoin levels of patients on gastrostomy tube feeding.

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Some fact of decreased phenytoin absorption in enteral feeding patients is that phenytoin interact enteral feeding product and adhere the nasogastric feeding tube itself. Tanaffos 2008735962. Concurrent administration of enteral tube feedings maypphenytoin absorption.   au yeung sc, ensom mh phenytoin and enteral feedings does evidence support an interaction? the feeds should be held for 12 hours before and after each phenytoin dose with adequate tube flushes before and after  similar to phenytoin, close monitoring of serum concentrations is warranted when carbamazepine is given via the enteral route.
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Most drugs are not licensed for administration via enteral feeding tubes. Continuous enteral feedings has been used extensively in critically ill patients  a patient on phenytoin being fed with fortison® through a nasogastric tube was observed to have a reduction of about 76% in enteral feeds vitamink containing potentially decrease the anticoagulant effect of acenocoumarol.
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Comparative effects of an elemental and a complex enteral feeding formulation on the absorption of phenytoin suspension. Dilantin levels with continuous delivery of enteral feedings a pilot study. Breast feeding the manufacturer does not recommend breast feeding because low concentrations of phenytoin are excreted in breast  26.   au yeung sc, ensom mh phenytoin and enteral feedings does evidence support an interaction? the feeds should be held for 12 hours before and after each phenytoin dose with adequate tube flushes before and after  similar to phenytoin, close monitoring of serum concentrations is warranted when carbamazepine is given via the enteral route.
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Continuous enteral feedings has been used extensively in critically ill patients  a patient on phenytoin being fed with fortison® through a nasogastric tube was observed to have a reduction of about 76% in enteral feeds vitamink containing potentially decrease the anticoagulant effect of acenocoumarol.   infant breastfeeding is not recommended for women taking this drug because phenytoin appears to be secreted in low concentrations enteral feedings may drastically reduce concentrations.
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  vegetables, cheeses and certain anticonvulsants agents phenytoin dilantin serum phenytoin concentrations may be decreased by continuous enteral feeds. Korner u, bondolfi a, buhler e, et al.   the classic study by bauer documenting this drugenteral feeding interaction in neurosurgical patients recommends to hold en two hours before and two hours after phenytoin administration.
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