Founded more than three decades ago, UK CPA is an online resource built by pharmacists for pharmacists in Texas
Why are there many pharmacists who aren’t involved in nutrition? When we were pharmacy students, we learned about protein, carbohydrates, fats, and fluids. Why not apply that knowledge in the treatment of patients?
Catabolic disease treatment
Catabolic patients burn amino acids for fuel, yet we want them to build protein to have the strength to get out of the hospital and recover from surgery or acute illness in the comfort of their own homes. Excess fats are bad for healthy people, but at 9kCal/g, you can’t beat it as an isotonic source of energy in the critically ill.
Pharmacists need to understand the role of carbohydrates in diabetic patients. Good blood sugar control post-MI has been shown to improve outcome by 30%. In septic shock, it improves outcome by 40%. This is more cost-effective than thrombolytics or activated protein C.
The unique contributions of a pharmacist (formulation knowledge, incompatibility experience, and skill in managing interactions)—it’s all in nutrition! Choosing the most appropriate formulation for a tube-fed patient can be challenging; who else the pharmacist knows what is available? What tablets can you crush, what can you substitute to get the same therapeutic effect; these are questions for pharmacists to answer.
And then there’s nutraceuticals. The enteral feed can do more than just feed patients. Immune-modulating feeds contain arginine, purine nucleosides, and omega-3 fatty acids to enhance white blood cell function yet suppress inflammation. This has been shown to reduce the length of stay, improve outcome, and reduce treatment costs.
Intensive care and cancer treatment
Intensive care and cancer patients often receive multiple antibiotics. This, in turn, selects out resistant organisms. Pharmacists should be involved in decisions to give more potent antibiotics or think laterally about alternative options. Have you considered lactobacillus capsules? This is an area worth exploring. Coordinate with the dieticians about the transfer of parenteral nutrition to enteral. That’s a team working, and it’s rewarding for staff and patients.
So who says pharmacists can’t be trained to manage nutrition? Pharmacy and nutrition should always go hand in hand when treating patients.