Małgorzata Krzyżaniak, Oliwia Sztuczka, Eliza Wolska, Małgorzata Sznitowska

Enteral nutrition and the role of the pharmacist in enteral drug administration

2026-06-01

Enteral Nutrition (EN), a form of clinical nutrition (CN), is increasingly implemented in the therapy of patients who are unable to maintain adequate oral intake. This nutritional support is administered via artificial access routes to the gastrointestinal (GI) tract and involves the delivery of specialized formulas and medications through nasoenteric tubes (nasogastric, nasoduodenal, or nasojejunal) or via enteral feeding stomas (gastrostomy or jejunostomy).

This publication presents and elucidates the process of enteral nutrition (EN), which should be understood as the administration of both nutritional substances and medicinal products. The article outlines patient qualification procedures for EN in accordance with the guidelines of the Polish Society for Parenteral, Enteral Nutrition and Metabolism (POLSPEN) while also accounting for contraindications to this process. In enteral nutrition, patients receive nourishment via tubes (nasoenteric tubes or gastrostomy/jejunostomy tubes in surgically created stomas) delivered directly into the stomach or the small intestine. The publication explains the criteria for selecting artificial access routes, their maintenance protocols, and the principles of safe administration. Furthermore, it provides a general characterization of enteral formulas, which are most commonly commercially prepared liquid medical foods.

A crucial component of enteral nutrition (EN) is the administration of medicinal products. While medications should ideally be administered in liquid form, many prescribed substances are available exclusively in solid dosage forms (tablets, capsules), necessitating their conversion into a liquid state. Summaries of Product Characteristics (SmPCs) often lack specific information on enteral administration routes, complicating the proper preparation of medications by medical personnel or caregivers. Consequently, the role of pharmacists is of paramount importance; by leveraging available standards and their knowledge of physicochemical properties, they can collaborate with physicians to establish correct preparation and administration protocols tailored to the individual patient. This article presents algorithms for preparing various dosage forms in accordance with current clinical standards.

In response to the persistently limited role of pharmaceutical counseling in hospital wards and nutrition clinics, this article discusses legal acts that recommend collaboration between pharmacists and other healthcare professionals involved in enteral nutrition. These regulations emphasize the importance of integrating pharmaceutical expertise into the multidisciplinary nutrition support teams to optimize patient outcomes.

Keywords: enteral nutrition, enteral drug administration, enteral nutrition tube, the role of pharmacist in nutritional support teams.

© Farm Pol, 2025, 81(11): 663–677