Final answer:
Dr. Shoulders noted that Phenytoin, an anticonvulsant drug, had an interaction with tube feeds. The interaction can lead to reduced drug absorption and decreased efficacy, requiring monitoring and possible dosage adjustments.
Step-by-step explanation:
According to Dr. Shoulders, the medication that had an interaction with tube feeds in the case discussed is C) Phenytoin. Phenytoin is an anticonvulsant used to control seizures. Unlike paracetamol (acetaminophen) and NSAIDs such as aspirin, ibuprofen or naproxen, which are pain relievers and have different mechanisms of action, phenytoin specifically can have reduced absorption when administered concurrently with tube feeding formulas. This is because the protein content and other constituents in tube feeds can bind with the drug, leading to decreased efficacy. It is crucial to monitor therapeutic drug levels and potentially adjust the dosage when phenytoin is given with enteral nutrition.
On the other hand, Advil—which is a brand name for ibuprofen—and Tylenol, which is a brand name for acetaminophen (paracetamol), are both analgesics, with the former being an NSAID and the latter being an analgesic and antipyretic. Fentanyl is a potent opioid pain reliever but does not have a noted interaction with tube feeds like phenytoin does. Therefore, the correct answer to the question is C) Phenytoin.