18 - Drug Nutrient Interactions -WJD 2011 handouts

18 - Drug Nutrient Interactions -WJD 2011 handouts - Drug,...

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Drug, Nutrient and Food Interactions HUN4445 April 14, 2011 ± Discuss pharmacotherapy as it relates to nutrition ± Identify ways that foods affect drugs and drugs affect nutritional status ± Describe some common drug-nutrient interactions ± Patients shall be educated how to safely use medications ² Food-drug interactions is one of 12 parameters ± Medications achieve intended effects ± Patients don’t discontinue drugs ± Need for additional medication decreased ± Adverse side effects avoided ± Optimal nutritional status preserved ± Disease complications reversed ± Cost of health care is reduced ± Less professional liability ± Pharmacodynamic interactions ² Effects on the pharmacologic action of the drug ² Binding to receptor or enzyme ± Pharmacokinetic interactions ² Effects on movement of the drug into, around or out of the body ± Absorption, distribution, metabolism excretion ± Foods and nutrients can affect drug kinetics ± Drugs can affect nutritional status
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± Genetics ± Malnutrition ± Polypharmacy ± Use of alcohol, herbal supplements ± Body weight ± Body composition ± Age ± Gende Gender ± General physical condition ± Oral ± IV ± Rectal ± Intramuscular (IM) ± Topical ± Subcutaneous ± Sublingual ± Inhalants ± First pass phenomenon ² concentration ± Half-life ± Minimum effective concentration (MEC) ± Minimum toxic concentration (MTC) ± Desired therapeutic range on of drug desired therapeutic range onset termination Time MTC MEC Plasma concentratio } “narrow” window “normal” window MTC MTC MEC MEC digoxin/digitalis/Lanoxin other drugs
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± Concentration ± Properties of the drug molecule ² Size ² Ionization ² Lipid solubility ² Blood supply at administration site ± Presence of food ² Fosamax has negligible absorption with food, only 60% with coffee or OJ: take 2 hours before meals ² Iron supplements: take on an empty stomach ² Food can enhance absorption à Saquinavir (anti HIV) absorption increases two-fold with food ² Fiber can inhibit drug absorption à E.g. fiber and digoxin ed for MEC Dose requir low fiber diet high fiber diet JP was admitted to the hospital complaining of severe indigestion and chest pains. He was diagnosed with atrial fibrillation and treated with Digoxin. JP was put on a low fiber, low fat diet in the hospital because of his “indigestion. The Digoxin dose was titrated to achieve the desired effect. JP was instructed to continue taking Clinical Application Question Digoxin at home. Which of the following is likely to happen when JP returns to his usual high fiber diet which includes bran cereal every morning? a. nothing, except that he may have a little gas at first
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This note was uploaded on 12/09/2011 for the course HUN 4445 taught by Professor Sitren during the Spring '08 term at University of Florida.

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18 - Drug Nutrient Interactions -WJD 2011 handouts - Drug,...

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