[Practice guideline for the administration of drugs with parenteral nutrition]

The "Y" administering of drugs or administering them during parenteral nutrition should not be a normal practice in daily clinical operations, due to the problems of the possible lack of physio-chemical stability in the lipid emulsion forming the mixture of aminoacids, glucose, lipids, electrolytes, vitamins and oligoelements or the chemistry of the drug itself with these components. Also, the "Y" administration of drugs in parenteral nutrition increases the risk of infection in the catheter, since it is handled much more often. Despite these problems, there are clinical situations (such as preoedema of the lung, inadequate syndrome of the antidiuretic hormone in bone marrow transplants), in which it is necessary to restrict to a minimum the fluids to be perfused. As an example, we could mention Ranitidine in TPN or the elimination of second line peripheric maintenance serum and the administering of other drugs in "Y" using a syringe or microdrop system. The same case as in patients subjected to bone marrow transplants, where due to polypharmacy and transfusions, drugs should be administered in "Y". This study is an updated review of the chemical stability of drugs administered in "Y" or in parenteral nutrition, and the physio-chemical stability of the lipid emulsion.