Individualized pharmaceutical care for a patient after pancreaticoduodenectomy with trypsin replacement nutritional therapy: A case report.


Journal

Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R

Informations de publication

Date de publication:
26 Aug 2022
Historique:
entrez: 31 8 2022
pubmed: 1 9 2022
medline: 2 9 2022
Statut: ppublish

Résumé

Optimal nutritional therapy for pancreaticoduodenectomy (PD) has been debated; however, little is known about key points of pancreatin enteric-coated capsule administration, a critical component of the PD treatment regimen. Patients often report elevations in tablet platoon and steatorrhea, and steatorrhea may adversely affect nutritional therapy for PD. Herein, we report a case of individualized pharmaceutical care for a patient after PD with trypsin replacement nutritional therapy. After PD with trypsin replacement nutritional therapy, the patient developed acute steatorrhea. Individualized pharmaceutical care was provided by clinical pharmacists to address intolerance to pancreatin enteric-coated capsules following PD. The clinical pharmacist's integration into the patient's treatment plan enhanced pharmacotherapy optimization, especially through pharmacokinetic monitoring and interventions related to nutritional therapy. Pharmaceutical care by clinical pharmacists aids in ensuring the safety and efficacy of drugs and nutritional treatment. Clinical pharmacists should be members of the nutrition support team.

Identifiants

pubmed: 36042676
doi: 10.1097/MD.0000000000030209
pii: 00005792-202208260-00095
pmc: PMC9410642
doi:

Substances chimiques

Pancreatin 8049-47-6
Trypsin EC 3.4.21.4

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e30209

Informations de copyright

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

The authors have no funding and conflicts of interest to disclose.

Références

Trapnell BC, Chen S, Khurmi R, et al. Hospitalization rates among patients with cystic fibrosis using pancreatic enzyme replacement therapy. Chron Respir Dis. 2020;17:147997311990061404143044.
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Gianotti L, Besselink MG, Sandini M, et al. Nutritional support and therapy in pancreatic surgery: a position paper of the International Study Group on Pancreatic Surgery (ISGPS). Surgery. 2018;164:1035–48.
Yuanchong J, Yuan D, Chen H, et al. Research progress of total pancreatectomy. Chin J General Surg2019;9:819–22.
Kuhn RJ, Gelrud A, Munck A, et al. CREON (Pancrelipase Delayed-Release Capsules) for the treatment of exocrine pancreatic insufficiency. Adv Ther. 2010;27:895–916.
Shlieout G, Koerner A, Maffert M, et al. Administration of CREON(R) pancrelipase pellets via gastrostomy tube is feasible with no loss of gastric resistance or lipase activity: an in vitro study. Clin Drug Investig. 2011;31:e1–7.
Kuhn RJ, Gelrud A, Munck A, et al. CREON (Pancrelipase Delayed-Release Capsules) for the treatment of exocrine pancreatic insufficiency. Adv Ther. 2010;27:895–916.
Xiaohong W. Study on disintegration time limit of four enteric-soluble capsules. Modern Med Health. 2008;15:2346.
Aloulou A, Puccinelli D, Sarles J, et al. In vitro comparative study of three pancreatic enzyme preparations: dissolution profiles, active enzyme release and acid stability. Aliment Pharmacol Ther. 2008;27:283–92.
Gan KH, Geus WP, Bakker W, et al. In vitro dissolution profiles of enteric-coated microsphere/microtablet pancreatin preparations at different pH values. Aliment Pharmacol Ther. 1996;10:771–5.

Auteurs

Song Zhang (S)

The First People's Hospital of Guangyuan, Guangyuan, China.

Qin Tan (Q)

The People's Hospital of Nanchuan, Chongqing, China.

Hanjun He (H)

The First People's Hospital of Guangyuan, Guangyuan, China.

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Classifications MeSH