Interactions Calculated between Medications and Enteral Nutrition Using an Updated Protocol in an Elderly Population in the Intensive Care Unit of a University Hospital in Central Brazil

Abstract

Introduction: Drug-nutrient interactions refer to alterations in the pharmacodynamics or pharmacokinetics of a drug due to interactions with physical, chemical, physiological, or pathophysiological factors related to nutrients. Objective: To investigate potential drug-nutrient interactions in patients receiving enteral nutrition admitted to an intensive care unit (ICU). Methods: This observational, descriptive, retrospective study employed non-probabilistic sampling of elderly patients at a university hospital in Brazil's Central Region. Potential drug-nutrient interactions were identified using the Up To Date® database, with interactions classified by risk level. Results: The study included data from 50 elderly patients, predominantly male (58%), with an average age of 70.6 ± 8.63 years. A total of 75 medications administered via the digestive tract were analyzed, of which 26 (34.66%) were found to have potential interactions according to Up To Date®, resulting in 47 types of pharmacokinetic interactions. Most interactions involved either the food/nutrient reducing the therapeutic effect of the drug or the drug lowering the serum level of the nutrient, accounting for 24 (51.06%) of the interactions. The average number of interactions was higher in deceased patients (1.5 ± 1.64) compared to those who were discharged (1.19 ± 1.44). Statistical analysis using the t-test (95% bilateral confidence interval) showed no significant difference between the groups (p-value > 0.99). Conclusion: The findings highlight the importance of monitoring drug-nutrient interactions in ICU patients, as these interactions can potentially have adverse effects on patient outcomes.