Prokinetic Agents with Enteral Nutrition

  • Ron R. Neyens
  • Melissa L. Hill
  • Michelle R. Huber
  • Julio A. Chalela
Living reference work entry

Abstract

Early and adequate enteral nutrition is associated with reduced morbidity and mortality in the critically ill patient, but due to high rates of enteral intolerance and concerns for aspiration and pneumonia, many patients do not receive it in a timely fashion. Although not definitively proven to reduce the rates of aspiration and pneumonia, prokinetic therapy has a modest benefit in improving enteral tolerance and delivery of enteral nutrition. Therapeutic selection is dependent upon the clinical scenario, patient’s comorbidities, drug-drug interactions, and end-organ function. Patients deemed to be at high risk of intolerance, prokinetic adverse events, or failed prokinetic therapy may benefit from placement of a post-pyloric tube.

Keywords

Placebo Magnesium Dopamine Pneumonia Acetylcholine 

List of Abbreviations

5-HT4

Serotonergic agonist

ACPO

Acute colonic pseudoobstruction

ASPEN

American Society for Parenteral and Enteral Nutrition

CCK

Cholecystokinin

CrCl

Creatinine clearance

CYP450

Cytochrome P450

D2

Dopaminergic antagonist

EPS

Extrapyramidal symptoms

ESPEN

European Society of Parenteral and Enteral Nutrition

GRV

Gastric residual volume

ICU

Intensive care unit

IV

Intravenous

TBI

Traumatic brain injury

VAP

Ventilator-associated pneumonia

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ron R. Neyens
    • 1
  • Melissa L. Hill
    • 2
  • Michelle R. Huber
    • 1
  • Julio A. Chalela
    • 2
  1. 1.Department of PharmacyMedical University of South CarolinaCharlestonUSA
  2. 2.Department of NeurosciencesCollege of Medicine, Medical University of South CarolinaCharlestonUSA

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