Food and Drug Interaction

Question 1

LR,a 67 yo , man, who has had depression was prescribed an MAOI (Monoamine Oxidase inhibitors) the following foods are avoided except

• Avocado
• bean curd
• bologna
• green tea

Answer 1

Green tea

Question 2

QUESTION : Patients taking COUMADIN, are advised not too increase or decrease their usual consumption in foods high in Vitamin K such as:

• broccoli
• brussels sprouts
• green tea
• all of the above

Answer 2

All of the above

Question 3

TRUE or FALSE : Allupurinol is prescribed for patients
with hyperuricemia, the appropriate diet to recommend is LOW
PROTEIN DIET

Answer 3

False

Question 4

Allupurinol is prescribed for patients

with hyperuricemia, the appropriate diet to recommend is to AVOID LOW PROTEIN DIET why?

Answer 4

AVOID LOW PROTEIN DIET. DO NOT
DRASTICALLY REDUCE DIETARY
PROTEIN INTAKE WHILE ON
ALLUPURINOL THERAPY.

A low protein diet will promote elevated
ALLUPURINOL levels.

Question 5

FLUOROQUINOLONES(Ciprobay,Tequin, Levofloxacin)
must not be taken with the ff: foods except :
• A. Caffeine
• B. Yogurt
• C. Papaya
• D. Dairy products

Answer 5

• C. Papaya

Question 6

REASON: FLUOROQUINOLONES(Ciprobay,Tequin, Levofloxacin)

must not be taken with the ff: foods except : PAPAYA

Answer 6

Calcium Rich foods like YOGURT, 
DAIRY PRODUCTS , and CAFFEINE 
(even Calcium, Mg , or Fe supplements) 
BIND TO FORM INSOLUBLE 
COMPLEXES.

Question 7

refers to the effect of a medication on food or

a nutrient in food

Answer 7

DRUG - NUTRIENT INTERACTION

Question 8

a broad term that includes drug nutrient
interactions and the effect of a medication
on nutritional status

Answer 8

FOOD DRUG INTERACTION

Question 9

MEDICAL TEAM MEMBERS should be
aware that therapeutically important food
and drug interaction can do the ff:

Answer 9

1. alter the intended response to
   the medication
2. cause drug toxicity
3. alter normal nutritional status

Question 10

JCIA

Answer 10

Joint Commission for International Accreditation

Question 11

parameter for Joint Commission for International Accreditation

Answer 11

• “PATIENTS ARE EDUCATED HOW TO USE
MEDICATION……….”
• One Parameter- Patient and Family must be
educated about FOOD- DRUG interactions

Question 12

2 BROAD TYPES OF FOOD DRUG INTERACTIONS

Answer 12

PHARMACODYNAMICS

PHARMACOKINETICS

Question 13

PHARMACOKINETICS

Answer 13

Affects the movement of

the drug

Question 14

PHARMACODYNAMICS

Answer 14

Pharmacologic action

of the drug

Question 15

Benefits of Minimizing Food Drug

Interactions

Answer 15

• Optimal nutritional status is preserved
• Accidents and injuries are avoided
• Disease complications are minimized
• The cost of health care services is reduced
• There is less professional liability
• Licensing agency requirements are met

Question 16

• Thought to be a HYPERSENSITIVITY

complex affecting the skin and mucous membrane

Answer 16

Stevens Johnson Syndrome

Question 17

Drugs known to interact with grapefruit juice:

Answer 17

• Anti-hypertensives
• Immunosuppressants
• Antihistamines
• Protease inhibitors
• Lipid-Lowering Drugs
• Anti-anxiety, antidepressants

Question 18

Anti-hypertensives

Answer 18

filodipine, 
nifedipine, 
nimodipine, 
nicardipine, 
isradipine

Question 19

Immunosuppressants

Answer 19

cyclosporine, tacrolimus

Question 20

Antihistamines

Answer 20

astemizole

Question 21

Protease inhibitors

Answer 21

saquinavir

Question 22

Lipid-Lowering Drugs

Answer 22

atorvastatin, lovastatin,

simvastatin

Question 23

Anti-anxiety, antidepressants

Answer 23

buspirone, 
diazepam, midazolam, 
triazolam, zaleplon, 
carbamazepine, 
clomipramine, trazodone

Question 24

MAOI

Answer 24

Monoamine oxidase inhibitors (MAOI)

Question 25

Monoamine oxidase inhibitors (MAOI) interact with what pressor agents in foods

Answer 25

(tyramine, dopamine, histamine)

Question 26

_______ are generally deaminated rapidly by MAO;

Answer 26

Pressors

Question 27

MAOIs prevent the breakdown of _____ and other | pressors

Answer 27

tyramine

Question 28

Significant intake of high-______ foods (aged cheeses, cured meats) by pts on MAOIs can precipitate _______ crisis

Answer 28

tyramine | hypertensive

Question 29

When foods containing TYRAMINE are consumed: | “ CHEESE SYNDROME “

Answer 29

individual may suffer from hypertensive crisis

Question 30

When foods containing TYRAMINE are consumed: HYPERSEROTONIMIA –

Answer 30

if foods containing | TRYPTOPHAN are consumed

Question 31

``` The following foods are high in TYRAMINE except : a. Salami, Bologna b. Sauerkraut c. Kosher salt d. Miso soup ```

Answer 31

c. Kosher salt

Question 32

A VASO CONSTRICTOR THAT RAISES BLOOD PRESSURE. | May trigger MIGRAINE ATTACKS

Answer 32

TYRAMINE

Question 33

FOOD SOURCES of TYRAMINE

Answer 33

* Aged Cheese * Processed Meats i.e. Salami, Pepperoni * Red wine , Beer * White wine 4 to 8 oz per day only * Processed soup i.e. Miso soup * Yeast extract

Question 34

• Increases adverse effects of stimulants such as amphetamines, methylphenidate, theophylline, causing nervousness, tremor, insomnia • Counters the antianxiety effect of tranquilizers

Answer 34

Caffeine

Question 35

The following foods have CAFFEINE , which among the following foods have the highest caffeine content ? a. Instant coffee b. Brewed coffee , drip c. Mountain Dew d. Brewed coffee, percolator

Answer 35

b. Brewed coffee , drip

Question 36

Foods that – increases ADVERSE EFFECTS OF | STIMULANTS

Answer 36

Caffeine in foods or beverages

Question 37

an (anticoagulant) acts by preventing the | conversion of vitamin K to a usable form

Answer 37

Warfarin

Question 38

Ingestion of vitamin ___ in usable form will allow production of more clotting factors, making warfarin less effective

Answer 38

K

Question 39

Other foods with anticlotting qualities may also have | an effect with warfarin (garlic, onions, vitamin E in large amounts, and ginseng) TRUE or FALSE

Answer 39

True

Question 40

``` • C.G. , 67 year old male , admitted at the Telemetry Unit , diagnosed with atrial fibrillation complications • Was prescribed a COUMADIN DIET • How will you counsel this patient? ```

Answer 40

For patients taking COUMADIN( Warfarin) • Do not increase or decrease usual consumption in foods high in VITAMIN K such as: ➢ broccoli , cauliflower , kale, lettuce ,cabbage spinach, turnip greens ➢ soy containing products ,soybean oil ➢ green tea ➢ brussel sprouts , onions-fried or boiled ➢ Beef liver

Question 41

DIAZEPAM

Answer 41

VALIUM

Question 42

BARBITURATE

Answer 42

PHENOBARBITAL

Question 43

ETHANOL

Answer 43

HEPATOXIC EFFECTS

Question 44

Food or nutrients can alter the intended | pharmacologic action of a medication by ____and by _____

Answer 44

by ENHANCING by OPPOSING

Question 45

Drug effects on Nutrition: Metabolism Phenobarbital Phenytoin

Answer 45

Increase metabolism of Vitamin D | Vitamin K and Folic Acid

Question 46

Drug effects on Nutrition: Metabolism | Carbamazepine

Answer 46

Affect metabolism of Biotin , Vitamin D, and folic acid May lead to possible depletion