Often ignored, exploring the aspect of drug and diet interaction is one of the vital aspects of approaching any healthcare case study. Hence, here are my slides to understand the complexities of the same.
2. B E G I N I N G W I T H T H E
INTRODUCTION
Diet is the sum total of foods
consumed by a person.
A drug is a substance which is not
food but a therapeutic agent used
in the prevention, diagnosis,
alleviation, treatment or cure of a
disease.
Nutrients are constituents in foods
that must be supplied to the body
in small amounts, and it includes
carbohydrate, fats, proteins,
vitamins, minerals and water.
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3. ( O M A N M E D J . , B U S H R A , R . , E T A L )
“Many medicines have powerful ingredients that interact with the
human body in different ways. Diet and lifestyle can sometimes have a
significant impact on drugs. A drug interaction is a situation in
which a substance affects the activity of a drug, i.e. the effects
are increased or decreased, or they produce a new effect that neither
produces on its own.”
Words to Live By
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4. Importance of knowledge
on Drug Nutrient
Interaction.
➢ The medications achieve their intended
purpose.
➢ A prescribed drug can be continued by the
patient.
➢ Supplementation of nutrients and calories is
minimal.
➢ Nutritional status is maintained.
➢ Side effects and disease complications are
reduced.
➢ The health care processes are inexpensive.
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On delving further, we can segregate the effect
of food and drugs on the metabolism of each
other.
5. N E X T
Delayed gastric emptying -
Altered gastrointestinal pH -
Competition for binding sites with the nutrients -
Adsorption or adhesion of food or a food component -
Chelation of drugs by food cations -
Dietary fats impeding the absorption of hydrophilic drugs -
Tetra porphyrins
Spironolactone
Ketaconazol
Anticoagulants
Digoxin
Tetracycline
Formation of insoluble complexes after getting chelated
with minerals -
Compete for binding sites with nutrients -
Damage intestinal mucosa -
Sequester bile salts -
Increase intestinal mobility -
Ciprofloxacin
Aspirin
Chemotherapeutic drugs.
Cholestyramine
Diarrhoea causing drugs
EFFECT ON ABSORPTION - The effect foods or its constituents have on drug metabolism and vice
versa can be positive or negative in nature, but both of them follow certain principles.
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6. N E X T
Grapefruit juice - Felodipine
Alcohol - CNS depressants, Propranolol.
The role food plays in the metabolism of drugs is vital as it is
completely based on altering enzymatic activities, which also
creates a facilitative or toxic environment, so needs to be
monitored carefully.
Some cited examples can be of:
Carbohydrate pathway - Insulin, Oral contraceptives
Lipid metabolism - Chlorpromazine, Phenobarbitone
Vitamin and mineral metabolism - Methotrexate,
antiseizure drugs
Drugs, especially in patients with lifestyle disorders, play a
significant role in the metabolism of foods and biochemical
pathways of nutrients. Some include:
EFFECT ON METABOLISM - The effect foods or its constituents have on drug metabolism and vice
versa is solely based on enzymatic and hormonal changes brought about by the either of the
two.
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7. N E X T
Foods can alter the reabsorption of drugs from the renal
tubules and the main factor affecting it is the acidity of the
urine. Therefore, a change in the urinary pH by the
food we consume influences the positive or negative impact on
the tubular reabsorption of drugs.
• A major example is of aspirin - ascorbate interaction.
Drugs influence the excretion of materials from our body, the
most relevant one here being diuretics. Along with sodium,
diuretics is also responsible for other mineral
losses from the body like potassium, zinc, calcium,
magnesium, etc.)
• Other than diuretics, tetracycline – an antibiotic – also
increases the excretion of ascorbate.
EFFECT ON EXCRETION
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8. Independent factors influenced by drugs and
foods on each other -
EFFECT OF
DRUGS ON
NUTRITIONAL
STATUS.
EFFECT OF
DRUGS ON
FOOD
INTAKE.
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EFFECT OF
FOOD IN THE
UTILIZATION OF
DRUGS.
9. The bioactive components of foods affect the
utilisation and effectiveness of drugs to a great
extent. If not studied, followed and monitored
properly, it can lead to sever toxicity.
One such example of relevance her is the action
of Monoamine Oxidase Inhibitors
(MAOI). MAOI are used to treat depression and
hypertension, and when coupled with fermented
or aged foods like aged cheese, fava beans, etc.,
it can rise to harmfully high levels due to
reaction with a component in these foods called
tyramine – a monoamine. This toxic
reaction can lead to severe headache,
haemorrhage and even death.
EFFECT OF FOOD IN THE
UTILIZATION OF DRUGS -
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10. Nutritional status is the condition of the body as
it relates to the consumption, and utilization of
food. It is defined as the health condition of an
individual influenced by his food and lifestyle
habits.
Some drugs (eg, metoclopramide) increase
gastrointestinal motility, decreasing food
absorption. Other drugs (eg, opioids,
anticholinergics) decrease gastrointestinal
motility. Some drugs are better tolerated if
taken with food. Certain drugs affect mineral
metabolism. Certain antibiotics (eg,
tetracyclines) reduce iron absorption, as can
certain foods (eg, vegetables, tea, bran). Certain
drugs affect vitamin absorption or metabolism.
EFFECT OF DRUGS ON
NUTRITIONAL STATUS -
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11. Anorexia
Nausea and vomiting
Gastrointestinal disturbances
Taste sensitivity
Increased appetite
Xerostomia
Soreness or pain in mouth
Mood swings and confusion:
The presence of a poor nutritional status is
often caused due to poor eating habits and
defective intake of food. The sole reason behind
it is the side effects drugs have on our body.
Some of the symptoms which adversely affect
the intake of food leading to poor nutritional
status are –
EFFECT OF DRUGS ON FOOD
INTAKE -
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12. D
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• Have side effects which influence appetite or gastrointestinal functions.
• Compete directly with a nutrient for its binding site.
Not all drug interactions are clinically significant either because poor nutritional
status, nutrient losses and adverse effects of drugs will be shown only when
practiced for a long period of time. But for drugs which are known to have
significant detrimental effects and need to be administered with certain
precautionary measure have the following features:
• Narrow threshold between therapeutic effect and toxicity
• Need to be taken for a prolonged period
• Have implications in terms of timing of food intake.
• Necessitate dietary restrictions and regulations.
13. CONCLUSION
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Thus, on a concluding note, interactions between drugs and food
products occur in various ways and in various steps ranging from
ingestion, absorption, metabolism, and excretion of both the
drug and food product. Some of the effects induced by food-drug
interactions, such as an increase in the blood drug level, may
have potential therapeutic benefits while some interactions may
result in detrimental physiological effects. It is therefore
important to understand and examine the potential interactions
between foods and drugs and their specific effects at an
individual level
14. N E X T
VOTE OF THANKS
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A F T E R A L L S A I D A N D D O N E , I T W O U L D B E
H I G H L Y U N J U S T I F I D O N ' T E X T E N D M Y
H E A R T F U L G R A T I T U D E T O R . A R I V U C H U D A R
M A ' A M O F P E R I Y A R U N I V E R S I T Y F O R T A K I N G
T I M E O U T F R O M H E R B U S Y S C H E D U L E T O
G U I D E M E I N S U C H A V I T A L T O P I C .
L A S T L Y , B U T N O T A T T H E V E R Y L E A S T , I
W O U L D L I K E T O T H A N K T H E A U T H O R S O F A L L
T H E B O O K S , R E S E A R C H P A P E R S A N D
J O U R N A L S , W H I C H W E R E R E F E R R E D T O I N
M A K I N G T H I S P R E S E N T A T I O N W E L L
R E S O U R C E D .
15. Bibliography
7th edition,
New Age
International
Publishers.
Dietetics,
Srilaxmi, .B
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2017
journal of
Lifestyle
Medicine,
Choi, J.H.;
et al,
2011
Oman Medical
Journal,
Bushra, R.;
et al,
All the information procured for this presentation has been reffered to
from the following resources: