Food-Nutrient Interactions Pt. 2

Question 1

what is the nutrient interaction with lithium carbonate?

high sodium diet? low sodium diet? dehydration?

Answer 1

lithium carbonate is tied to Na resorption in the renal tubule
- recommendation is to maintain consistent sodium intake
- high sodium: risk for therapuetic failure
- low sodium: risk for toxicity

Question 2

how does urinary pH impact drug excretion?

Answer 2

drugs that are weak acids or bases are resorbed in rental tubule in nonionic states
- a change in urinary pH by extreme diets may alter amounts of drug in nonionic state
- could increase or decrease drug resorption

Question 3

drug-nutrient interaction: cholestryamine

Answer 3

reduces the absorption of fat soluble vitamins
possibly folate and B12

it blocks the resorption of bile

Question 4

drug action: cholestryamine

Answer 4

anti-lipidemic

Question 5

drug effects on nutrient intake

(5)

Answer 5

1. appetite
2. taste (dysgeusia, hypergeusia)
3. nausea
4. dry mouth
5. mucositis (stomatitis, glossitis, cheilitis)

Question 6

drug-nutrient interaction: captopril

Answer 6

metallic taste and/or hypogeusia

an ACE inhibitor

Question 7

drug-nutrient interaction: clarithromycin

Answer 7

bitter taste

an antibiotic

Question 8

drug-nutrient interaction: eszopiclone

Answer 8

bitter taste

a sedative-hypnotics

Question 9

drug-nutrient interaction: anticholinergic drugs

(4)

Answer 9

• dry mouth + mucositis
• decreased intestional secretions
• slow peristalsis
• constipation (could lead to impaction)

Question 10

drug effects on nutrient absorption

(4)

Answer 10

• alters absorption (stomach pH, reduced IF, decreased absorption of ADEK, iron, folate)
• alters transit time or motility
• alters bile acid secretion/activity
• induces mucosal damage

Question 11

drug-nutrient interaction: methotrexate

and current recommendations

Answer 11

blocks conversion of folic acid to tetrahydrofolic acid
- should give folate in reduces form (colonic acid)

chemotherapy

Question 12

drug-nutrient interaction: TB drugs

Answer 12

blocks activation for pyridoxine to pyridoxal-5-phosphate
depletes B6

often not an issue, since TB drugs typically aren’t taken for long periods of time

Question 13

drug-nutrient interaction: anticonvulsants

Answer 13

stimulate cytochrome P450 enzyme to increase metabolism of folate, vit D, K, and B12

Question 14

types of diuretics

(3)

Answer 14

• loop diuretics
• thiazide diuretics
• K-sparing diuretics

Question 15

drug-nutrient interaction: loop diuretics

increase? decrease?

prescribed for what?
supplement with what?
where do they act?

Answer 15

in the body…
increases Na
decreases K, Mg, Ca

prescribed for fluid retention
often supplement K
loop of henle

Question 16

drug-nutrient interaction: K-sparing diuretic

increase? decrease?

where do they act?

Answer 16

in the body…
decreases Na, Cl, and Ca
increases K

acts in the distal convoluted tubule

Question 17

thiazide diuretic action

Answer 17

• increased Na, K, Mg excretion
• decreased Ca excretion

Question 18

drug-nutrient interaction: thiazide diuretic

Answer 18

hypokalemia, hypomagnesemia, hypercalcemia

hyperuricemia (high uric acid), gout

Question 19

thiazide diuretic recommendations

Answer 19

• watch calcium supplementation and excess water consumption
• encourage K and Mg in diet, particuarly in older patients

Question 20

ACE inhibitors action

Answer 20

inhibits enzymatic (angiotensin-cov enzyme) conversion angio 1 to angio II in the renin-aldosterone-angiotensin system

Question 21

drug-nutrient interaction: ACE inhibitors

Answer 21

hyperkalemia

dizziness, vertigo, fatigue

Question 22

ACE inhibitors recommendation

Answer 22

avoid K supplements, K-containing salt substitutes
caution with exercise

Question 23

Ca channel blockers action

Answer 23

inhibit L-type cellular channels -> vasodilation
no effect on caridac contractility or conduction

Question 24

drug-nutrient interaction: Ca Channel Blockers

Answer 24

dose dependent
headache, lightheadedness, flushing, peripheral edema

Question 25

Ca channel blockers recommendations

Answer 25

caution with exercise

Question 26

Beta blockers action

Answer 26

beta-adrenoreceptor blockage (blocks epi action)
prevent intracellular K+ uptake

Question 27

drug-nutrient interaction: beta blockers

Answer 27

hyperkalemia (after intake with some meds)
hypoglycemia (decreased glycogenolysis, gluconeogenesis) or hyperglycemia
weight gain

Question 28

beta blockers recommendation

Answer 28

avoid K supplements, K-containing salt substitutes
caution with exercise

Question 29

drug-nutrient interaction: corticosteriods

why are they prescribed?

Answer 29

• hyperglycemia, hypertension
• decreased bone density, bone fracture
• moon face, thinning skin

reduce inflammation, supress immune symptoms

Question 30

drug-nutrient interaction: MAO inhibitors

why?

Answer 30

must be on a low tyramine diet

to avoid hypertensive crisis

Question 31

drug-nutrient interaction: levothyroxine

Answer 31

coffee and food decreases absorption

T4 hormone drug

Question 32

drug-nutrient interaction: Tamoxifen

Answer 32

hoppy beers decrease the action

cancer drug

Question 33

drug-nutrient interaction: theophylline

Answer 33

tea increases the action

asthma and COPD drug

Question 34

drug-nutrient interaction: Tamil

Answer 34

echinacea, labrador tea, goldenseal, chai hu tea decrease potency

antiviral

Question 35

drug-nutrient interaction: Allegra

Answer 35

black pepper increases potency

antihistamine