Unit 8: Drugs and Nutrition K Eichmann, MS, RD

 Reduced appetite  Taste changes  Decreased motility  Offensive odors  Nausea/vomiting  Increased appetite (weight gain)

 Bioavailability of the drug when taken with certain foods  Changes in drug or nutrient absorption  The small intestine is the main site for absorption

 Nutrients play a role in drug metabolism, therefore a decreased amount of a nutrient can decrease the metabolism of the drug  Toxicity of a drug may be increased or decreased by changing the metabolism of the drug.

 Drugs may change the excretion of a drug by altering reabsorption or transport  Foods can change urine pH, and alter the excretion of drugs

Who would be at risk of altered nutritional health due to medication usage? Why?

 Make a drug more or less effective  Minerals can affect absorption  Some medications are to be taken with food and some with out. This relates to the getting the appropriate response from the drug.  Sometimes they are taken with meals to decrease GI upset, but may result in decreased absorption.  High fat, low fiber meals may delay gastric emptying

 May affect absorption of vitamins  May compete with vitamins for sites of action  And as seen before, drugs can interfere with intake of foods and effect appetite.

 Tyramine – MAOI, tyramine can react with a compound in the drug and lead to a hypertensive crisis  ETOH withdrawal meds – Don’t use ETOH, will have adverse effect  ETOH, hot beverages, antacids – not with extended release tablets as these examples can prematurely erode the pH sensitive coating  Be careful with OTC meds and supplements as these may interact

1. What are the severe effects of hypervitaminosis A in infants? 2. The amount of drugs appearing in breast milk depends upon which 3 primary factors? 3. What are some of the characteristics of the FAS infant? 4. What are some of the effects of alcohol on pregnant women?

5. The effects of OCA’s depend upon four characteristics of the user. What are the four characteristics? 6. What are the three most important reasons that the elderly have adverse reactions to drugs? 7. What are 3 examples of the most common drug- nutrient interactions among the elderly?

 Review: Multiple Choice Questions 8-10  Review: True or False Questions 11-16

 ETOH – FAS, other nutrient deficiencies in the mother (Folic Acid, Mg, Zn) may play a role in FAS  Caffeine – just a warning, teratogenic in rate  Additives – mother w/ PKU, avoid aspartame  Negative effect on fetus from recreational use  It varies, but there is risk of passing drugs through the breast milk

 Polypharmacy  OTC and prescription drugs  Decreases in absorption, metabolism and excretion (may stay longer in the body)