W10 - Nutrient Interactions Flashcards
What can medication do to nutrient absorption?
⬇️ or prevent it
What is a chelation reaction?
Metal ion + organic complexing agent –> Ring structure encompassing the metal ion + removes it.
What do chelation reactions between medications + minerals (metal ions) do?
What is the advice that follows this?
⬇️ amount of mineral avail. for absorption.
Advice - Take minerals at least 2 to 6 hrs apart from drug.
What is adsorption?
Adhesion of atoms, ions or mol from a gas, liquid or dissolved solid to a surface.
Creates a film of the adsorbate on the surface of the adsorbent.
What is absorption?
Fluid (absorbate) is dissolved by or permeates a liquid or solid (absorbent).
What can adsorption do to nutrient absorption?
⬇️ it
What drug is known to treat diarrhoea?
Bile acid sequestrant cholestyramine (Questran)
What does Bile acid sequestrant cholestyramine (Questran) do?
ADSORBS fat-sol vitamins A,D,E+K.
What does it mean that Bile acid sequestrant cholestyramine (Questran) adsorbs A,D,E+K?
Should recommend vitamin supplementation w/ LT use of this drug, especially when taken more than once a day.
Bile acid sequestrant cholestyramine (Questran)
What vitamin supplementation is recommended?
30ml + of mineral oil/ day
= ⬇️ absorption of vit A,D,E+K
It is advised to take the mineral oil a.m + vitamins 2+hrs later.
How can drugs reduce nutrient absorption?
By influencing transit time of food + nutrients in gut.
What reduce transit time of food + nutrients in the gut?
Cathartic agents + laxatives
What can cathartic agents + laxatives cause?
What can this then lead to?
Diarrhoea
Loss of Ca2+ + K+.
What else can diarrhoea be induced by?
Drugs containing sorbitol, i.e syrup or solution forms of furosemide.
Drugs that ⬆️ peristalsis, i.e Cytotec.
How might a drug prevent nutrient absorption?
By changing the GI env.
What might antisecretory drugs be used to treat?
Ulcer disease + GERD.
How do antisecretory drugs treat Ulcer disease + GERD?
Inhibit gastric acid secretion + ⬆️ gastric pH.
== Impairs absorption of V B12 by ⬇️ cleavage from its dietary sources.
What do the drugs do that have the biggest effect on nutrient ABSORPTION?
Those that damage the intestinal mucosa.
Damage to the intestinal mucosa
Damage to the structure o the villi + microvilli inhibit the brush-border enzymes + intestinal transport systems involved in nutrient absorption.
What does damage to the gut mucosa commonly result from?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
LT antibiotic therapy
What is the science of nutrigenomics?
Science of nutrients + the genes.
How naturally occurring chemicals in foods can alter mol expression of genetic info in each ind.
What does nutrient intake affect?
Genomics
Proteomics
Metabolomics
== Then impacting disease prevention + +ive health outcomes.
What is genomics
Make up of genes + the gene expression
What is proteomics
Creation of the gene
What are the 3 nutrient-gene interactions?
Direct interactions
Epigenetic interactions
Genetic variations
NUTRIENT-GENE INTERACTIONS
Direct interactions
Sometimes after interacting w. a receptor, nutrients behave as transcription factors meaning they can bind to DNA + acutely induce gene expression.
NUTRIENT-GENE INTERACTIONS
Epigenetic interactions
Nutrients can alter the structure of DNA so that gene expression is chronically altered.
NUTRIENT-GENE INTERACTIONS
Genetic variationsT
Common genetic variations i.e single-nucleotide polymorphisms (SNPs) can alter the expression of functionality of genes.
What is meant by genetic expression?
Transcription
Translation
Post-transcriptional + translation modification
== End product = Proteins
What are nutraceuticals?
Products for nutrition + medicine.
What may nutraceuticals be used for?
Improve health
Delay ageing process
Prevent chronic diseases
Support structure/function of the human body
According to Nasri et al. 2014, what is the frequency use of nutraceuticals in developed countries?
50-70%
What is pharmacokinetics?
Absorption, distribution, metabolism and excretion of drugs.
What can drug nutrient interactions (DNI) do?
Alter the effectiveness of a drug
Cause a nutrient depletion
How can a DNI cause a nutrient depletion?
By disruption absorption
⬆️ excretion of 1 or more nutrients
What are the increased risks of a DNI?
Older adults
Those who take multiple medications (poly pharmacy)
Those taking medications w/ dietary supplements
In what ways can drugs influence the bodys nutritional status?
Ingestion (via appetite or taste)
Secretion (via oral secretion + gastric acid secretion)
Absorption (via GI transporters or GI drug metabolising enzymes)
GI motility
GI flora (immunity)
Nutrient metabolism
Nutrient excretion
What are the nutrient related side effects of medication?
GI distress
Blood sugar imbalance
Appetite changes
Weight gain/loss
Organ toxicity
What can be the most prominent examples of a specific pharmacokinetic food-drug effect interaction?
Grapefruit juice + Felodipine
What can be the most prominent examples of a specific pharmacokinetic food-drug effect interaction?
Grapefruit juice + Felodipine
What can the interaction result in?
Inhibition of CYP3A4 metabolism
Inhibition of uptake + efflux membrane transporters.
Recommendations regarding DNI
Avoidance of certain foods w/ many drugs i.e grapefruit
Change timing of foods around taking drugs
Screen patients routinely for supplement + herbal use
