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MNT Prep > Drug Nutrient Interactions > Flashcards

Drug Nutrient Interactions Flashcards

1
Q

Type 2 FDI: pharmacodynamic

A

How the drug acts at target tissue

Binding Enzymes, channels, receptors

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2
Q

How do statins work?

A

They bind the HMG CoA enzyme system to block the production of cholesterol.
(Pharmacodynamic)

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3
Q

Type 3 of FDI: pharmacokinetic

A

Time the drug spends in body due to absorption, distribution, metabolism, and elimination.

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4
Q

How does albumin affect drug activity/distribution?

A

Drugs bind to be transported in blood.
When bound=drug is inactive.
Unbound= physiologically bio active

No albumin–> increases drug toxicity

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5
Q

What is the main metabolic (bio transformation) system for drugs?

A

Cytochrome P450 system in the liver and other tissues

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6
Q

What are steps and end result of cytochrome P450 system?

A

Phase 1- oxidize/hydrolyze/reduce
Phase 2- make metabolites water soluble

Either eliminated by kidney as urine or by liver and GI as poop from bile

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7
Q

What is the effect of drug is liver/renal failure occurs?

A

Excretion decreases; drug toxicity increases

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8
Q

What do appetite lowering drugs do?

A

Hypogeusia (no taste)
Dysgeusia (changed taste)
N/V
Brain chemistry changed (serotonin uptake stopped, increased NE)

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9
Q

Neoplasm

Antineoplastic

A

Tumor

Chemotherapy drugs- stop growth of new tumors

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10
Q

What is the effect of cisplatin (antineoplastic drug)?

A

Causes things to taste badly- dysgeusia
Causes N/V
Chemotherapy Tx

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11
Q

Serotonergic drugs do?

A

Stop serotonin uptake, increase satiety, and decrease food intake (cause weight loss)

Ex- dexfenfluramine (Fen Fen)

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12
Q

Adrenergic drugs?

A

Increase satiety and energy expenditure
Decrease appetite and weight
Vasoconstrictor and cause high BP

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13
Q

Amphetamines do?

A

Higher NE release
Decrease by mouth intake
(Type of andrenergic)

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14
Q

Type 1 FDI: Pharmaceutical

A

Depends on drug properties

Dose, form, solubility (food increases or decreases)

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15
Q

3 examples that increase weight (sometime appetite):

A

Corticosteroids ( higher wt and BG)
Megace ® for pt who is wasting away
Propofol (anti anxiety) causes higher wt b/c in TF and emulsion of soybean oil. (Kcal per mL)

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16
Q

Examples that decrease Nutrient Absorption?

A 
Laxatives 
Have sorbitol (osmotic effect cause diarrhea) 
Causes vomiting 
Decreases GI secretions (IF or bile) 
Change gut pH
Damage microvilli (laxatives)
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17
Q

Theophylline (lower nutrient absorption)

A

Contains sorbitol so causes diarrhea

In a lot of TF

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18
Q

Cholestyramine (lower nutrient absorption)

A

Binds bile acids so they can’t be recycled
Intention: lower cholesterol

Actually: lower bile means lower fat absorption

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19
Q

Cimetidine (lower nutrient absorption)

A

Antisecretory

Decreases IF secretion so B12 depletion

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20
Q

How do antacids effect nutrient absorption?

A

They increase the pH of the GI tract (more basic) and cause it to eliminate more minerals and absorb less minerals

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21
Q

Long term ASA can?

A

Damage microvilli and decrease Ca and Fe absorption.

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22
Q

What nutrient does chemotherapeutic drugs compete with?

A

Folate because folate is needed for cell division. Blocks folate so cell division for cancer can quit.

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23
Q

If on Tb drug, INH (isonaizide), what vitamin should be supplemented?

A

B6 because the INH binds B6

24
Q

What vitamin does Coumadin interact with?

A

Vitamin K.

K works to clot blood and warfarin works to prevent blood clotting. Do not eat too much vitamin K if on this drug.

25
Q

Explain the definition, process and outcomes of MAOIs?

A

Monoamine oxidase inhibitors- antidepressant
The drug stops MAO from oxidizes/breaking down tyramine in system.
Tyramine vasoconstrictor and causes high BP.
If never broken down, high BP all the time, tachycardia, heart failure.
GOAL: avoid foods with tyramine when on this drug.

26
Q

Foods with tyramine

A 
Fermented anything
Beer 
Home pickles 
Aged cheese 
Smoked meats
27
Q

What nutrients do laxatives affect?

A

Lower Ca and K absorption

28
Q

What type of meds inhibit metabolic enzyme activity (cytochrome P450)?

A

Renal meds

29
Q

What compound is in grapefruit?

What products have it?

A

epoxybergamottin (increase drug availability)

Frozen concentrates, commercial juice, PEEL, squirt, fresca

Fresh pulp only seems safe

30
Q

What is the grapefruit effect?

A

Grapefruit juice inhibits enzyme pathways from breaking down/metabolizing statin and calcium channel blocker medications. This increases drug availability by 50% and increases toxicity.

31
Q

Effect of natural licorice

A

Glycyrrhizic Acid
Release cortisol, increase Na retention, increase water, high BP (anti diuretic)!
Laxative

AVOID IF ON DIURETIC!

32
Q

What does Antabuse do?

Used to stop alcoholics from drinking by causing nausea

A

It stops aldehyde dehydrogenase so aldehyde (breakdown from alcohol) accumulates

Raise tachycardia and BP

33
Q

Alcohol + fasting =

A

No gluconeogenesis

34
Q

Anti-inflammatory drug interactions (steroids)

A

Decrease Ca absorb (increase excretion)
(Osteoporosis and growth retardation)

Increase protein loss

Retain NaCl so retain a lot of fluids

35
Q

Prednisone (type of drug, side effects)

A

Anti-inflammatory drug (retain H2O, less Ca)

Raises blood glucose and weight

Drug induced DM

36
Q

Anti-inflammatory drug interactions (NSAID)

A

Causes GI bleeding which leads to

Anemia

37
Q

What do Loop diuretics (Lasix) do to excretion?

A

Increase excretion of:

K+ (K wasting)
Na 
Ca 
Mg
Zn 
Cl
38
Q

What do Thiazide diuretics (HCTZ) do to excretion of nutrients?

A

Increase excretion of :

K
Na
Mg
Cl

Saves and re absorbs Ca

39
Q

What does spironolactone do to k?

A

K sparing (re absorbs)

40
Q

Dilantin (Phenytoin)

drug type and what nutrition issues

A

Anticonvulsant

Decreased folate, vitamin D and biotin absorption
Changes gut pH

41
Q

Oral contraceptives (nutrition issues)

A

Increase folate excretion

Increase circulating Vit A and RBP synthesis

42
Q

Prednisone (drug type and issues)

A

Anti- Inflammatory

Lower Ca absorption and increased Ca excretion (osteoporosis risk)

High protein loss

NaCl retention (edema)

Increased blood glc and weight gain (DM)

43
Q

Key nutrient to monitor on diuretics

A

Potassium!

44
Q

What might happen to K levels if on Lasix (furosemide)?

A

K wasting– it will be excreted

So, K levels might fall even more (switch drug if too low)

45
Q

K wasting diuretics….2 types?

A

Loop diuretic (Lasix)

Thiazide diuretic ( HCTZ)

46
Q

What might happen to K+ levels on Alactone (spironolactone)?

A

K+ levels get higher

K sparing diuretic (re absorbs K in kidney and puts bAck into blood)

47
Q

If a pt has edema, what might happen to their drug dosage?

A

Dosage increases because over hydration means a larger volume needs the drug.

Caution: change dosage when edema is gone

48
Q

What happens to drug dosage when dehydrated?

A

Lower the drug dosage because less fluid/blood to absorb through.

Low dose doesn’t last long b/c saline drip will be administered.

49
Q

Propofol (drug type and issue)

A

Sedative

In liquid emulsion so contains calories

50
Q

D5W (drug type and issue/why?)

A

Hydrating solution of dextrose and water.

Contains kcals that need considered in TPN

51
Q

3 people types who metabolize drugs slowly (lower doses needed)?

A

Infants
Children
Elders

52
Q

If CBW is used vs AdjBW for obese drug doses, what could happen?

A

Increased risk of toxicity b/c adipose tissue slows drug clearance from body and CBW dose would be larger.

53
Q

2 broad spectrum antibiotic examples, what happens, and what risk increases?

A

Ampicillin and Gentamycin
Normal bacterial flora in intestine altered
C. Diff risk high
(Diarrhea yellow, acidic, smelly)

54
Q

What are downfalls of C diff?

A

Diarrhea serious

Low nutrient absorption and higher excretion

55
Q

If Cytochrome P450 is not working (liver disease) what is the risk?

A

Drug toxicity (hepatotoxicity)

56
Q

2 drug types that cause nephrotoxicity?

A

Antineoplastics and antibiotics

57
Q

Drugs that cause hepatotoxicity?

A

Statins, cordarone, Elavil, methotrexate

MNT Prep (27 decks)

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