NUTR 395 Lecture Notes - Lecture 11: Sugar Substitute, Polypharmacy, Vomiting
Food-Drug Interactions
I. Interactions
a. JCAHO requires monitoring by RD
i. Translation of that varies
b. Risk
i. Increases with
1. Increased number of drugs
a. Polypharmacy – multiple drugs
2. Increased dosage levels
3. Increased time on drugs
c. Interactions occur at several levels
II. Drug Changes Intake
a. Increase appetite/weight (Table 11.3)
i. Steroids
ii. Antihistamines
iii. Valium-type
iv. Antipsychotic
b. Dry mouth – probably causes decreased intake - problem when dealing with
malnourished clients
i. Antihistamines
ii. Diuretics
1. dehydration
iii. Antineoplastic
c. Decrease appetite/weight (Table 11.4)
i. Antidepressants
ii. Amphetamines
iii. Antibiotics
iv. Antineoplastics
d. Alter taste
i. Antineoplastics
ii. ACE-inhibitors
1. Blood pressure control
III. Drug Changes Absorption
a. Emesis (vomiting)
i. Chemotherapy
ii. Antibiotics
iii. FE+- containing
b. Diarrhea
i. Antibiotics
ii. Mg+ -containing
iii. Sorbitol containing
1. sugar-free sweetener
2. Added to many medications to get patients to take them
iv. Increased osmotic load
Not expected to memorize drugs
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Document Summary
Interactions: jcaho requires monitoring by rd, translation of that varies, risk, increases with. Increased number of drugs: polypharmacy multiple drugs. Drug induced electrolyte alterations: sodium, increased with sodium containing drugs (parenteral, decreased with diuretics, laxatives, potassium, increased with k-sparing diuretics, beta-blockers, decreased with loop diuretics, work in the loop of henley. Effect of food on drug absorption: decreased, aspirin, atenolol, captopril, ampicillin, penicillin, levodopa, methyldopa, delayed, aspirin, cefador (cephalexin, ciprofloxin), tagamet, digoxin, furosemide, iron, enhanced, valium, propranolol, erythromycin. Effects of pem on drug therapy (protein energy malnutrition: gi alteration, increased transit time, decreased enzyme secretions, ph changes, plasma, decreased albumin, volume changes, hepatic changes, decreased detoxification, decreased metabolism, renal changes, decreased excretion, decreased resorption. Major concerns: warfarin & vitamin k, blood thinner/anti-coagulant, blocks vitamin k important for clotting, if feeding excess vitamin k can override and decrease effects of drug can be harmful, keep vit.
