By: Stephanie Temple RDN, LD
Recently, in two different facilities, I was approached by nurses who were having difficulty with clogged enteral feeding tubes. Both times, I was told “I really have a hard time getting that Omeprazole to go through.” Omeprazole comes in a capsule and, when opened, the little beads inside are difficult to get through a feeding tube. A helpful pharmacist at Zellmed Pharmacy provided some guidance (3).
Omeprazole: This is an antisecretory medication that is a proton pump inhibitor. It suppresses gastric acid secretion by inhibiting the H+, K+ – ATPase enzyme system (the proton pump) in the parietal cells. This suppresses gastric acid secretion and relieves gastrointestinal distress and promotes ulcer healing (1).
Prevacid Solutabs: This is also an antisecretory proton pump inhibitor, so it is the same classification as Omeprazole and acts in the same way (1). It is available as a solutab tablet (disintegrating), making it a better choice for enteral tube administration. Prevacid is also available as a packet of granules meant to be mixed with water in order to form a suspension. This suspension, however, contains xanthan gum which can potentially expand in an enteral feeding tube causing blockage (2). Prevacid Solutabs require prior authorization where Omeprazole does not (3).
Zantac Liquid: Like Omepazole and Prevacid, this is an antisecretory medication. It is an H2 receptor antagonist. It inhibits histamine action at H2-receptor sites on parietal cells, blocking gastric acid secretion (1). Because this is a liquid, it will not clog feeding tubes. It is preferable to utilize a liquid dosage form whenever possible for enteral feeding tube administration, especially if the patient has a small-bore feeding tube (2). Zantac Liquid does not require prior authorization (3).
Medications cause obstruction in about 15% of patients receiving enteral tube feedings (2). We, as Registered Dietitian Nutritionists, can assist the nursing staff to avoid this complication.
(1) BillieAnn, W., Margaret, S., & Kelly, S. (2013). Nurse’s Drug Guide. Boston: Pearson.
(2) Wyman, M. (). Medication Administration Through Enteral Feeding Tubes. Cleveland Clinic Pharmocotherapy Update, XI.
(3) Zellmed Pharmacy
February is Heart Health Month. Special attention to heart disease is warranted as it represents the number one killer of women in the United States, claiming more lives than all forms of cancer combined. In fact, while breast cancer claims 1 in 30 female lives, heart disease is responsible in the deaths of 1 in 3 females.
Today is National Wear Red Day! Since its inception in 2004, the American Heart Association’s Go Red campaign has assisted in saving 627,000 lives as a result of increased awareness. To show our outgoing support of this worthy cause, our office wore RED today!
I encourage you to take a moment to review the following strategies to reduce your risk of heart disease:
Adapted from information provided by the Centers for Disease Control (CDC) and www.goredforwomen.org
By: Larissa Brophy MS, RDN, LD
There are a collection of go-to-foods in my arsenal. Not all are “natural” or “wholesome”, but they work on those busy days. It is not always easy to eat healthy (requires preplanning), but I find it to be tasty and rewarding. Food with flavor is far superior than the fat laden alternatives, seriously. And healthful eating can be more economical and easier than most convenience foods. You just need to pack a lunch bag with snacks or stock your purse, desk, and/or car with some of these items.
By: Diana Weathers RDN, LD
Some workdays can be busier than others. On those busy days, we often find ourselves working through lunch usually eating at our desks. It is always encouraged to eat away from your desk, but this is not always possible with our hectic schedules. There are some measures you can take to make sure you don’t go for the quick, fast food options that can throw your healthy eating completely off for the week!
By: Cyndi Guveiyian RDN, LD
The Academy of Nutrition and Dietetics’ Board of Directors and the Commission on Dietetic Registration recently adopted the optional use the credential of “registered dietitian nutritionist’ (RDN) for registered dietitians.
The Academy began exploring the option of offering the registered dietitian nutritionist credential in 2010. It was supported by participants in the 2011 Future Connections Summit and most recently by the Council on Future Practice in its 2012 Visioning Report. The recommendation was shared and discussed in the House of Delegates in 2012. The 2013 joint meeting of the major organizational units (Commission on Dietetic Registration, Accreditation Council for Education in Nutrition and Dietetics, Council on Future Practice, Education Committee, and Nutrition and Dietetics Educators and Preceptors DPG) supported moving forward. Hence, the RDN credential is now available for optional use by registered dietitians.
By: Cyndi Guveiyian RD, LD
The Academy of Nutrition and Dietetics recently published the 4th edition of the International Dietetics and Nutrition Terminology (IDNT) Reference Manual. Although there are changes to standardized language or terminology for each step of Nutrition Care Process outlined in the 4th edition, the changes in Step 2: Nutrition Diagnosis are most noteworthy. This is especially true since standardized language must be used for Nutrition Diagnoses. The changes are as follows:
By: Cyndi Guveiyian RD, LD
National Women’s Health Week is May 12-18, 2013! This weeklong health observance coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health brings together communities, businesses, government, health organizations, and other groups in an effort to promote women’s health and its importance.
Women often serve as caregivers for their families, putting the needs of their spouses, children, and parents before their own. Too often, a woman’s health and well-being become secondary. Does this sound familiar? It’s time to take action and put the focus on a very important person…YOU!
The U.S. Department of Health and Human Services’ Office on Women’s Health recommends following five steps to improve your physical and mental health and lower the risk of certain diseases:
As a community, we have a responsibility to support the important women we know and do everything we can to help them take steps for longer, healthier, happier lives. Most importantly, we owe it to ourselves as women to put ourselves first on occasion. We work hard each day to keep all the balls in motion and synchronized in perfect harmony. We deserve to be around to see the fruit of our labor! What will you do to promote women’s health? Share your comments.
www.womenshealth.gov (accessed 5.13.13)
By: Brenda Gerdeman DTR
Diabetes is the 7th leading cause of death in the United States. Did you know that 8.3% of the U.S. population or 25.8 million people have diabetes? It is also alarming that approximately 7.0 million or 27% of those individuals are undiagnosed. In Ohio, 10.1% of the adult population has been diagnosed with diabetes whereas another 3.0% of Ohioans are undiagnosed. So what can be done to help?
There is a “warning” condition called Pre-Diabetes that can occur before the onset of Type II Diabetes Mellitus. According to the American Diabetes Association, Pre-Diabetes can be diagnosed when fasted blood glucose levels range from 100-125 mg/dL, glycosylated hemoglobin (HgA1C) levels range between 5.7%-6.4%, or an abnormal oral glucose tolerance test (not commonly tested). When blood glucose control falls within these ranges, it is a strong indicator that lifestyle changes should occur to reduce your risk of developing Type II Diabetes