Keeping the calcium:phosphorus solubility product ... - RM Solutions

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Peroxide Formation • It has been shown that TPN admixtures in multilayered bag present less oxidation evaluated by hydroperoxide formation [1,2]. • TPN bag has low oxygen permeation and could be collapsed to eliminate, as much as possible, the oxygening the bag. • Moreover, the presence of amino acids [3,4] in formulations containing trace elements, lipids and vitamins [5] decrease the peroxide formation and its clinical complications [3,6]. 1. Steger PJK, Muhlebach SF. Nutr 1997, 13 (2), 133-140. 2. Balet A et al. J Parenter Enteral Nutr 2004, 28:85-91. 3. Lavoie JC et al.. Pediatrics 1997, 99(3):e61-5. 4. Bhatia J et al.. J Pediatr 1980, 96, 284-286. 5. Silvers KM et al. Acta Paediatr 2001, 90(3):242-249 6. Lavoie JC et al.. Pediatric Pulmonology 2005, 40:53-56
• During the 6 hours after TPN preparation the balance between generation and consumption of peroxides is positive, and after this time they presume that the balance changed in favor of the consumption, during their transformation into free radicals via the Fenton-like reaction induced by trace elements present in the PN solution. [1] • Although it was shown that the vitamin solutions cause more peroxidation, some vitamins have been shown to have antioxidant effects, as vitamin C. • The oxidation of amino acids and vitamin C could prevent the lipid peroxidation turning the peroxidation undetectable. 1. Lavoie JC et al. 1997 Admixture of a multivitamin preparation to parenteral nutrition: The major contributor to in vitro generation of peroxides. Pediatrics, 99(3):e61-5.
Page 1: Parenteral Nutrition Formulations:
Page 4 and 5: Pharmacist Responsibilities cont.
Page 6 and 7: Parenteral Nutrition Prescriptions
Page 8 and 9: Calcium and Phosphate • Preterm i
Page 10 and 11: Depiction of dibasic calcium phosph
Page 12 and 13: Factors affecting TPN Compatibility
Page 14 and 15: pH Effects • The pH of the final
Page 16 and 17: • Since the eye can only detect p
Page 18 and 19: • TPN is a potential source of ox
Page 20 and 21: • Fat sources used in the manufac
Page 22 and 23: • Concerns for the potential of l
Page 24 and 25: Osmolarity: The Big Question? • O
Page 28 and 29: • The physical stability of the l
Page 30 and 31: Mixing: 3 in 1 vs 2 in 1? Advantage
Page 32 and 33: • Less nursing time needed for 1
Page 34 and 35: • Less attractive in pediatric se
Page 36 and 37: The calcium/phosphorus ratios for P
Page 38 and 39: Osmolarity (mOsm/L) = [(grams dextr
Page 40 and 41: Review of Access Devices Used for N
Page 42: Factors which affect the formation

Keeping the calcium:phosphorus solubility product ... - RM Solutions

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