Nurs 226 Patho and Pharm: Week 1 Medication and Dietary Restrictionsl

Warfarin (Blood Thinner)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Vitamin K rich foods like kale, spinach etc

2. Vitamin K reduces effect → INR swings (how long blood takes to clot)

3. Keep vitamin-K foods consistent week to week

MAOIs/ Linezolid (Prescription Antibiotic)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Tyramine foods like aged cheese, curse meats, soy sauce

2. Can lead to hypertensive crisis risk

3. Low-tyramine diet; avoid for 2 weeks after MAOIs

What does grapefruit do that can make it harmful to take with certain drugs, including statins?

Inhibits CYP3A4 leading to a potentially toxic rise in drug levels

Statins (Simvastatin, lovastatin) (Lowers bad cholesterol and triglycerides)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Grapefruit

2. Increases drug levels leading to muscle toxicity risk

3. Avoid grapefruit, use other citrus or different statin

Fluoroquinolones (Ciprofloxacin, etc.) (Antibiotic)

[What foods should you not take with this medication]

[Why does it matter]

[How to do it right]

1. Dairy or antacids

2. Calcium binds the drug leading to poor absorption

3. Take 2 hours before or 4-6 hours after dairy/antacids

Tetracyclines (Antibiotic)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Dairy, iron, magnesium, zinc at the same time

2. Minerals chelate drug leading to poor absorption

3. Separate by a few hours

Levothyroxine (Treats hypothyroidism)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Food, soy, fiber, calcium/iron same time, grapefruit

2. Food and minerals impair absorption

3. Take on empty stomach; separate calcium/iron by 24 hours

Bisphosphonates (alendronate) (Prevents loss of bone density/ treats osteoporosis)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Food, beverages, calcium/antacids

2. Blocks absorption and increases esophagitis risk

3. Take AM with plain water and stay upright for 30-60 mins

Metronidazole (Antibiotic and antiprotozoal (antiparasitic))

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Alcohol (including hidden sources)

2. Disulfiram-like reaction

3. No alcohol during & 48-72 hours after treatment

Disulfiram (Treats alcoholism)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. All alcohol (including sauces, vinegars, syrups)

2. Triggers severe reaction

3. Avoid alcohol during & 14 days after last dose

Lithium (Mood-stabilizer)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Avoid low-sodium diets, dehydration & caffeine swings

2. Changes drug levels leading to toxicity risk

3. Keep salt & fluids consistent; avoid dehydration

ACE inhibitors/ARBs (Lower BP/Relaxes blood vessels)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Avoid potassium salt substitutes, very high-K diets

2. Hyperkalemia risk

3. Avoid low salt products; moderate high-K foods

Spironolactone (Diuretic for fluid retention, HF and High BP)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Potassium salt substitutes and very high-K foods

2. Increases Potassium leading to arrhythmia risk

3. Avoid salt substitutes; limit big K loads

Iron supplements

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Tea, coffee, dairy, antacids, high-phytate meals

2. Blocks absorption

3. Best on empty stomach with vitamin C; separate from dairy/antacidsioD

Digoxin (Treats heart failure and atrial fibrillation)

[What foods should you avoid or limit]

[Why does it matter]

[How to do it right]

1. Very high-fiber meals, herbal products

2. Fiber reduces absorption

3. Take same time daily, separate from high-fiber meals

Dairy/mineral supplements often block which four types of medications?

thyroid meds, bisphosphonates, tetracyclines, fluoroquinolone

Which two types of drugs is alcohol risky with?

Metronidazole and disulfiram

Consistency is key for which two drugs?

warfarin and lithium