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NUTR 406 > Exam 1: Drug Nutrient Interactions > Flashcards

Exam 1: Drug Nutrient Interactions Flashcards

1
Q

what is the significance of drug-nutrient interactions (DNI)?

A

Foods can interfere with the bodies ability to absorb a medication, reducing the dose or increasing absorption, which can improve availability of the drug or post the risk for toxicity

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2
Q

What are the 2 pharmacologic aspects of drug-nutrient interactions (DNI)?

A
  • Pharmacodynamics
  • Pharmacokinetics
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3
Q

What are pharmacodynamics?
examples

A

Biochemical and
physiological effects of a drug

examples: drug-receptor interaction, patients functional state, placebo effect

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4
Q

What are Pharmacokinetics

A

⚬ Absorption (GI tract and administration site)
⚬ Distribution (blood)
⚬ Metabolism (liver, kidney, sites of action)
⚬ Excretion (bile or urine)

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5
Q

If drug is metabolized in the liver, how is it excreted?

A

Bile

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6
Q

If drug is metabolized in the kidney, how is it excreted?

A

urine

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7
Q

Interaction effects of pharmacologic aspect of drugs depend on:

A

⚬ Type of medication
⚬ Form of drug
⚬ Dosage
⚬ Site of absorption
⚬ Route of
administration

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8
Q

Describe effects of food on drug therapy

A

Absorption
Physical incompatibility
Bioavailability

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9
Q

What is the effect of food on drug therapy during absorption in the following: IV drugs

A

IV drugs have 100% bioavailability absorption because it is administered IV directly to blood

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10
Q

What is the effect of food on drug therapy during absorption in the following: orally

A

medicine administered orally decreases in bioavailability

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11
Q

What is the effect of food on drug therapy during absorption in the following: stomach/gastric

A
  • Gastric emptying rate affect absorption by delaying it specially when eating high fat meals or high fiber meals
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12
Q

What is the effect of food on drug therapy during absorption in the following: chelation

A
  • Chelation - binding of a drug with a mineral
  • certain medications can bind with cation minerals such as Fe Ca Mg
  • Chelation can enhance or dec absorption
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13
Q

What is the effect of food on drug therapy during absorption in the following: adsorption

A

Adsorption- binding drug with another substance

  • examples phytate, oxalates,
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14
Q

What is the effect of food on drug therapy during absorption in the following: pH

A
  • GI pH can inc or dec a drug absorption
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15
Q

What is Enteral Nutrition?

A
  • tube feeding when a patient is NPO
  • formula food administered via tube goes through GI tract
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16
Q

Concerns with enteral nutrition

A
  • physical incompatibility
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17
Q

What do you do with Enteral nutrition when physical incompatibility on drug therapy occurs?

A

Flush tube with water
before and after medication
administration

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18
Q

What medicine is affected by food bioavailability on drug therapy during enteral nutrition?

A

⚬ Dilantin- anti-seizure medication
⚬ Hold tube feeding for 2 hrs
before and after each dose

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19
Q

how can albumin affect the distribution nutrients/food and drug therapy?

A

⚬ Albumin is a transport protein that can binds numerous drugs
⚬ Low albumin = larger fraction of unbound drug in the bloodstream

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20
Q

what 3 things affect albumin level

A
  • protein malnutrition
  • edema
  • inflammation
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21
Q

how can grapefruit affect the metabolism of nutrients/food and drug therapy?

A

⚬ Substance in grapefruit inhibits the metabolism of certain drugs (statins-cholesterol)
⚬ leads to More drug in circulation, thus possible toxicity

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22
Q

how can sodium and lithium affect the excretion of nutrients/food and drug therapy?

A

⚬ Sodium and lithium
⚬ Low Na intake promotes lithium resorption lead to toxicity
⚬ High Na intake promotes lithium excretion thus drug is not as effective

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23
Q

How can food and nutrients modify drug action?

A
  • enhance drug effects
  • decrease drug effects
24
Q

Describe the foods and meds that decrease drug effects

A

⚬ Caffeine and depressants
⚬ Alcohol and stimulants
⚬ Vitamin K (coagulant) and warfarin (anticoagulants)
⚬ Licorice and hypertension meds
Licorice and hypertension meds

25
Q

Describe the foods and meds that enhance drug effects

A

⚬ MAOIs (antidepressant drugs) and tyramine
⚬ Caffeine and stimulants
⚬ Vitamin E/omega-3 and warfarin
⚬ Alcohol and depressants, NSAIDs, potentially hepatotoxic drugs, insulin, oral
hypoglycemic, and morphine

26
Q

Explain MAOIs and tyramine interaction

A

MAOIs prevent breaksown of pressors such as tyramine.

Pressors cause sudden increase in blood pressure causing hypertension

Foods to avoid: aged cheeses, fermented beverages and foods, cured meats,

27
Q

Explain Caffeine and stimulants interaction

A
  • stimulants stimulate CNS and heart rate

Caffeine and stimulants lead to too much stimulation

28
Q

Explain Vitamin E/omega-3 and warfarin interaction

A
  • Warfarin is a anticoagulant or blood thinner
  • VitE/omega-3/fish oils act as a blood thinner
29
Q

What medicines should you avoid with alcohol

A

depressants, NSAIDs, hepatotoxic drugs, insulin, oral
hypoglycemic, and morphine

30
Q

Alcohol and depressants, NSAIDs, potentially hepatotoxic drugs, insulin, oral
hypoglycemic, and morphine

A

alcohol is a CNS depressant, raise glucose level lead to hypoglycemia

NSAIDS: mucosal irritants, irritate lining in stomach and making more susceptible to stomach ulceration or gastritis

  • toxicity of morphine
31
Q

How does Chelation decrease the effects of drugs on nutrient absorption?

i.e. antibiotics

A

Chelation is when a medication binds to a cation (metal)

  • Antibiotics bind to calcium

recommendation: consume Ca separate from abx dose 2 hours before or after

32
Q

How does adsorption decrease the effect of drugs on nutrient absorption?

i.e. Questran

A
  • adsorption is binding with anything not a mineral

Questran is a cholesterol drug that binds to bile. Bile is needed for absorption of fat-soluble vitamins

  • Questran and fat-soluble vitamins

recommend: supplement fat-soluble vitamins

33
Q

How does transit time decrease the effect of drugs on nutrient absorption?

i.e. laxatives

A
  • laxatives inc transit time
  • can cause loss of potassium and zinc in stool do to inability to absorb it fast enough
  • laxatives and potassium and zinc
34
Q

Which 3 GI environment decrease the effect of drugs on nutrient absorption?

A

⚬ pH:
⚬ Intestinal mucosa:
⚬ Gut flora:

35
Q

Which GI environment decrease the effect of drugs on nutrient absorption?

environment: pH

A

⚬ pH: anti-GERD drugs and iron and B12

  • anti GERD dec acidity in stomach
  • Fe and B12 require acidic environment for absorption
  • recommend : supplement Fe and B12
36
Q

Which GI environment decrease the effect of drugs on nutrient absorption?

environment: intestinal mucosa

A

⚬ Intestinal mucosa: NSAIDs and iron

  • NSAIDS irritate linning of stomach and mucos production
  • loss of iron becuase iron not absorbed
37
Q

Which GI environment decrease the effect of drugs on nutrient absorption?

environment: But flora

A
  • antibiotics kill bacteria

⚬ Gut flora: antibiotics and vitamin K

recommend vit K

38
Q

What two drugs block conversion of vitamins to active form during nutrient metabolism

A

Isoniazid (tuberculosis med) block B6
Methotrexate (cancer treatment, rheumatoid arthritis, ectopic pregnancy) block folic acid

39
Q

What drugs inhibit enzymes during nutrient metabolism

A
  • statins (cholesterol-lowering) inhibit coenzyme Q10
  • statins block hmp cholesterol reductase
  • Q10 important for reduce heart disease
40
Q

Describe the effects of drugs on nutrient excretion

i.e. potassium

A

may inc or dec excretion by interfering with resorption

  • lasix diuretics promote urination so lose fluids and potassium
  • potassium wasting or potassium-sparing diuretics
  • supplement potassium
41
Q

6 Effects of drugs on nutrient status

A

Sensory effects
GI effects
Appetite changes
Hepatotoxicity
Nephrotoxicity
Corticosteroids

42
Q

Sensory effects of drugs on nutritional status

A

Taste
Smell

43
Q

Taste effects of drugs on nutritional status

A

⚬ Dysgeusia: altered taste-metalic
⚬ Hypogeusia: dec/loss of taste
⚬ Xerostomia: dry mouth
⚬ Antineoplastics: anti chemo med

44
Q

Smell effects of drugs on nutritional status

A

⚬ Dysosmia: alter smell
⚬ Hyposmia: dec smell
⚬ Anesthesia:

45
Q

GI effects of drugs on nutritional status

A
  • Irritation and ulceration (NSAIDs)
  • Nausea and vomiting: antineoplastics
  • Constipation: narcotics/opioids
  • Diarrhea: antineoplastics, laxatives, abx
46
Q

What drugs cause Irritation and ulceration of drugs on nutritional status

A

NSAIDS

47
Q

What drug cause Nausea and vomiting effects of drugs on nutritional status

A

antineoplastics

48
Q

What drugs cause constipation effects of drugs on nutritional status

A

Narcotics and Opiods

49
Q

What drugs cause Diarrhea effects of drugs on nutritional status

A

antineoplastics
laxatives
Abx

50
Q

What drugs cause anorexia effects of drugs on nutritional status

A

anorexia=lack of appetite

  • CNS stimulants
  • antineoplastics
51
Q

What drugs cause increased appetite effects of drugs on nutritional status

A
  • antipsychotics
  • antidepressants
  • gain weight
52
Q

What drugs cause hepatotoxicity effects of drugs on nutritional status

A
  • hypotoxicity = liver damage
    Antihyperlipidemics
    e.i. statins and high levels of niacin
53
Q

What drugs cause nephrotoxicity effects of drugs on nutritional status

A
  • nephrotoxicity= kidney damage
  • antineoplastics
54
Q

What symptoms do corticosteroids meds have that effect nutritional status?

A

what is does - anti inflamatory
when - chronic inflammatory disease
side effects:
- increase appetite lead to weight gain
- raised blood sugar hyperglycemias
high blood pressure hypertension
impair absorption of vitamin D and Ca
-

55
Q

What are the 6 potential interactions caused by drug excipients

A

excipients added for shelf life of drugs

  • Allergies
  • Lactase deficiency
  • Gluten sensitivity
  • Sugar alcohol intolerance (-tols)
  • Added calories from sugars or fats
  • Diprivan/Propofol (sedative) contains 1.1 kcals/mL (inc fat caloies)

NUTR 406 (9 decks)

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