Basics Of Pharmacy: Total Parenteral Nutrition | TPN | PPN

Tuesday, November 2, 2021

Total Parenteral Nutrition | TPN | PPN

TPN is a medical term and tpn means total parenteral nutrition, it is the type of parenteral nutrition in which nutrients are administered to the person through the veins, bypassing or avoiding the gastrointestinal tract.

What Is Parenteral Feeding Or Parenteral Nutrition?

Parenteral feeding or parenteral nutrition is a broader term and is used for the administration of nutrient fluids into the body using veins instead of the GI tract.

Parenteral Feeding is further divided into two types one is TPN (total parenteral nutrition) and the other is PPN (Peripheral parenteral nutrition)

What IS TPN / Total Parenteral Nutrition

In simple words, TPN is a liquid preparation containing all the important ingredients required to the body and are administered through the large vein known as superior vena cava.

TPN is also defined as the feeding system which bypasses the GIT system.

The TPN system was first developed by Dr Stanley Dudrick in 1960.

What IS PPN?

PPN is the type of intravenous feeding or parenteral feeding in which nutrients are administered to the body using peripheral intravenous lines rather than central lines. It is used for short term or temporary supply of nutrients.

When To Use TPN

As we discussed earlier TPN is the bypassing of GIT so it is used when there is a serious problem in the functioning of GIT or in any disease condition which makes it impossible to take food or nutrients orally.

For Whom TPN Is Used

Although TPN is the method of nutrition administration, it is not a normal feeding system, which means it is not used for healthy patients.

  • TPN is used for those patients who are not able to take food through the gastrointestinal tract due to some disease conditions.

  • TPN is used for those patients who are in a coma and are not able to take food through gastrointestinal tracts.

  • TPN is used for premature babies to improve their health.

  • TPN is used for those patients who are elderly and their GIT absorption is reduced.

  • TPN is administered to those patients who have a blockage in their GIT.

  • TPN is administered to those patients who have a leakage in their GIT.

  • TPN is also administered to patients suffering from short bowel syndrome.

  • TPN is administered to the patients having severe diarrhoea.

  • TPN is used for cancer patients.

  • TPN is also administered to patients who are suffering from intestinal bleeding.

  • TPN is administered to the patient who is recommended for long-duration bowl rest.

What Are Complication Of TPN

As we know that TPN is not the method of oral administration and it is administered through veins so it may result in the following complications,

  • Catheter Infection may occur due to the administration of TPN using a needle system.Septic shock may result in harm to life.

  • Blood clotting may occur.

  • Long term usage of TPN may fail the liver functioning or may result in the fatty liver.

  • Feeling of hunger.

  • Administration of medicines along with TPN may result in severe complications due to incompatibility.

Components OF TPN

Patients receiving TPN are dependent on intravenous fluids so TPN solutions should contain all the essential and required nutrients so that the basic dietary needs of patients may be met.

Before TPN administration patients nutrient requirements are calculated and then TPN is administered according to the condition.

Following are the main components of TPN Solution,

  • Lipids

  • Amino Acids

  • Fats

  • sugar

  • Vitamins

  • Dextrose

  • Potassium

  • Calcium

  • Sodium

  • Chloride

  • Magnesium Ions

  • Trace elements

  • Added substance

Added substances are mixed in tpn preparations depending on patient requirements.

Preparation Of TPN

TPN is prepared by qualified pharmacists in hospital pharmacy. For accurate administration of nutrients, TPN calculations are done daily according to the patient's conditions and requirements.

TPN Route Of Administration

TPN is administered by using a catheter into the central vein which directly leads to the heart.

Duration Of TPN

Parenteral nutrition is recommended to patients for short term and long term duration.

The administration of TPN fluid usually takes 10-12 hours a day.

Life with TPN is somewhat difficult because a long duration is required for its administration.

Instructions For TPN

Following instructions should be followed for TPN,

  • Always check Patient name before administration.

  • Do not administer a TPN bag if it is expired.

  • Do not administer the TPN bag if it leaked.

TPN at Home Or Hospital

TPN can be administered to the patient both at home or hospital depending upon the condition of the patient.

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