Abstract:
OBJECTIVE To summarize and analyze 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 carrie out in vitro experiments to initially explore their interaction mechanism and influencing factors, aiming 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 was completely solidified. In addition, the pH value of the solution of acetyl cysteine mixed with TPF-D in effervescent tablets was lower than that of granules, and it was easier to form precipitate.
CONCLUSION There is an obvious incompatibility between TPF-D and strongly acidic acetylcysteine solution. Concomitant use of TPF-D with strongly acidic medications, such as acetylcysteine effervescent tablets, should be avoided in clinical practice to prevent complications like esophageal obstruction.
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