US EPA

8157025 

Journal Article 

Vitamins and minerals in total parenteral nutrition - Pharmaceutical aspects 

Antunović, M; Putić, V; Mirković, D; Panišić, M; Tarabar, D 

2009 

59 

2-3 

226-237 

Serbian 

A total parenteral nutrition (TPN) admixture refers to the provision of all required nutrients, exclusively by the intravenous route. TPN admixtures are complex formulations that generally include energy supplied as dextrose and fat, proteins, electrolytes, vitamins, trace elements and water. These components usually need to be individualized for patients. As it is known the TPN admixtures are very complicated sistems, we should pay attention on their stability, because of their physico-chemical interactions between their components. Today, the responsibility for the compounding of save parenteral nutrition admixtures for patients incapable of oral or enteral nutrition primarily rests with the pharmacy department. Total parenteral nutrition admixtures are clearly the most complex pharmaceutical dosage forms routinely compounded by pharmacists on a daily basis. The sheer number of individual chemical entities that compose these infusions approach 50 or more components. The most important thing for the pharmacist is to be sure about physical and chemical stability of this admixtures and microbial quality by preventing contamination during aseptic compounding.Two types of instability can occur, in the lipid portions, which is perhaps the most senzitive part, and in the corresponding water phase. In conclusion, the pharmacist as an expert in compounding and in preventing instability or incompatibility is challenged to provide TPN admixtures of the highest pharmaceutical quality. To increase safety and stability of TPN admixtures, microbial and physico-chemical quality assurance have to be considered carefully. 

Minerals; Total parenteral nutrition; TPN stability; Vitamins