Food-Nutrient Interactions Pt. 2 Flashcards
what is the nutrient interaction with lithium carbonate?
high sodium diet? low sodium diet? dehydration?
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
how does urinary pH impact drug excretion?
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
drug-nutrient interaction: cholestryamine
reduces the absorption of fat soluble vitamins
possibly folate and B12
it blocks the resorption of bile
drug action: cholestryamine
anti-lipidemic
drug effects on nutrient intake
(5)
- appetite
- taste (dysgeusia, hypergeusia)
- nausea
- dry mouth
- mucositis (stomatitis, glossitis, cheilitis)
drug-nutrient interaction: captopril
metallic taste and/or hypogeusia
an ACE inhibitor
drug-nutrient interaction: clarithromycin
bitter taste
an antibiotic
drug-nutrient interaction: eszopiclone
bitter taste
a sedative-hypnotics
drug-nutrient interaction: anticholinergic drugs
(4)
- dry mouth + mucositis
- decreased intestional secretions
- slow peristalsis
- constipation (could lead to impaction)
drug effects on nutrient absorption
(4)
- 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
drug-nutrient interaction: methotrexate
and current recommendations
blocks conversion of folic acid to tetrahydrofolic acid
- should give folate in reduces form (colonic acid)
chemotherapy
drug-nutrient interaction: TB drugs
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
drug-nutrient interaction: anticonvulsants
stimulate cytochrome P450 enzyme to increase metabolism of folate, vit D, K, and B12
types of diuretics
(3)
- loop diuretics
- thiazide diuretics
- K-sparing diuretics
drug-nutrient interaction: loop diuretics
increase? decrease?
prescribed for what?
supplement with what?
where do they act?
in the body…
increases Na
decreases K, Mg, Ca
prescribed for fluid retention
often supplement K
loop of henle
drug-nutrient interaction: K-sparing diuretic
increase? decrease?
where do they act?
in the body…
decreases Na, Cl, and Ca
increases K
acts in the distal convoluted tubule
thiazide diuretic action
- increased Na, K, Mg excretion
- decreased Ca excretion
drug-nutrient interaction: thiazide diuretic
hypokalemia, hypomagnesemia, hypercalcemia
hyperuricemia (high uric acid), gout
thiazide diuretic recommendations
- watch calcium supplementation and excess water consumption
- encourage K and Mg in diet, particuarly in older patients
ACE inhibitors action
inhibits enzymatic (angiotensin-cov enzyme) conversion angio 1 to angio II in the renin-aldosterone-angiotensin system
drug-nutrient interaction: ACE inhibitors
hyperkalemia
dizziness, vertigo, fatigue
ACE inhibitors recommendation
avoid K supplements, K-containing salt substitutes
caution with exercise
Ca channel blockers action
inhibit L-type cellular channels -> vasodilation
no effect on caridac contractility or conduction
drug-nutrient interaction: Ca Channel Blockers
dose dependent
headache, lightheadedness, flushing, peripheral edema
Ca channel blockers recommendations
caution with exercise
Beta blockers action
beta-adrenoreceptor blockage (blocks epi action)
prevent intracellular K+ uptake
drug-nutrient interaction: beta blockers
hyperkalemia (after intake with some meds)
hypoglycemia (decreased glycogenolysis, gluconeogenesis) or hyperglycemia
weight gain
beta blockers recommendation
avoid K supplements, K-containing salt substitutes
caution with exercise
drug-nutrient interaction: corticosteriods
why are they prescribed?
- hyperglycemia, hypertension
- decreased bone density, bone fracture
- moon face, thinning skin
reduce inflammation, supress immune symptoms
drug-nutrient interaction: MAO inhibitors
why?
must be on a low tyramine diet
to avoid hypertensive crisis
drug-nutrient interaction: levothyroxine
coffee and food decreases absorption
T4 hormone drug
drug-nutrient interaction: Tamoxifen
hoppy beers decrease the action
cancer drug
drug-nutrient interaction: theophylline
tea increases the action
asthma and COPD drug
drug-nutrient interaction: Tamil
echinacea, labrador tea, goldenseal, chai hu tea decrease potency
antiviral
drug-nutrient interaction: Allegra
black pepper increases potency
antihistamine
