NBCD - Nutrient-Drug Interaction (copy)

Drug

Substance, other than food, used in diagnosis, cure, mitigation, treatment, and prevention of a disease

Drug-nutrient interaction

The result of the action between a drug ans a nutrient that would not occur with the nutrient or drug alone

Food-drug interaction

A broad term thay includes nutrient-drug interacrions and the effect of a medication on nutritional status

Pharmacodynamics

The study of interactions between drug and receptors and the series of events that result in a pharmacologic response

Pharmacokinetics

The study of the mathematical relationship among absoprtion, distribution, metabolism, and excretion of individual medicines over time

Iatrogenic malnutrition

"Physician-induced" malnutrition

Probiotics

A functional food containing live microorganisms prescribed to patients taking anti-infective drugs

Clostridium difficile

A bacteria which causes antibiotic-associated diarrhea

Sulfamethoxazole/tripmoptherin

Antibacterial (sulfonamide) drug which interferese with folate metabolism

Sodium, Potassium

Minerals which may be found high in amoxicillin.

Macrolides (-mycins)

Antibacterial drugs which increase the sedative effect of alcohol

Fluoroquinolones (-floxacins)

Antibacterial drug which binds to Mg, Ca, Zn, and Fe to form insoluble, unabsorbable complex

Linezolid

Antimicrobial drug (Oxazolidinone) which exhibits mild monoamine oxidase inhibition, thus tyramine-containing foods are avoided.

Tetracycline (-cycline)

A class of antimicrobials used in treating lyme disease which binds to minerals, lower gut vitamin K production, B vitamin deficiencies in long term usage, and, in combination with vitamin A, could result to increased intracranial hypertension

Metronidazole

An antiprotozoal drug which, when ingested with alcohol, may cause disulfiram-like reaction. Thus alcohol should be avoided during and 3 days after use.

Estrogen

Oral contraceptive which decreases Vit C and increases vitamin A, respectively. It also affects folate metabolism and lower serum B12, riboflavin, Mg and Zn

Levothyroxine

Thyroid hormone drug which is affected (lowered) by Fe, Ca, Mg, and high fiber foods.

Digoxin

A cardiovascular drug which increases urinary loss of Mg and lower serum K

Metaprolol, atenolol

Cardiovascular drugs (beta blocker) which mask signs of or prolong hyperglycemia.

Carvedilol

A cardiovascular drug (beta blocker) which may mask diabetic hyperglycemia and cause weight gain. Natural licorice and high sodium is to be avoided.

ACE inhibitors ("prils")

A class of cardiovascular drugs which may increase serum potassium and cause GI distress. Salt substitutes, licorice, and high K are avoided.

Angiotensin II Receptor Antagonists (-artans)

A class of cardiovascular drugs which may increase serum potassium. Salt substitutes, licorice, and high K are avoided.

Amlodipine

A calcium channel blocker which may cause nausea, cramps, dysphagia, and edema.

Diltiazem

A calcium channel blocker which causes anorexia, dry mouth, dyspepsia, nausea, vomitting, and GI distress

Hydralazine

A cardiovascular peripheral vasodilator drug which interfere with pyridoxine metabolism

HMG Coa-reductase inhibitors/Statins

Class of antihyperlipidemic drugs which significantyl decrease Co Q10. It lowers LDL while raising HDL.

Fibrates

Class of antihyperlipidemic drugs which decreases serum tryglycerides

Cholestyramine

Antihyperlipidemic drug (bile acid sequestrant) which binds fat soluble vitamins, carotene, minerals, and folate.

Niacin

Antihyperlipidemic drug which may elevate blood glucose and uric acid at high doses

Nitrofurantoin

An antibacterial drug (Nitrofuran) which can lead to wasting with pre-existing anemia, vitamin B deficiency, or electrolye abrnomalities. Avoided by G6PD patients

Izoniazid

An antitubercular which may cause pyridoxine and niacin deficiency. It also affects vitamin D metabolism, lowers Ca and P absorption, and possess MAO inhibitor-like activity.

Ethambutol, Pyrazinamide

Antituberculars which lowers the excretion of uric acid, potentially resulting to hyperuricemia and gout.

Amphotericin B

Antifungal drug which induces anorexia, weight loss, and Mg, K, and Ca loss

Ketoconazole

A drug which should be taken with acidic drinks because it does not dissolve in pH >5

Warfarin

An anticoagulant prevents the conversion of vitamin K to its active form, causing anticoagluation

Dabigatram

A anticoagulant (direct thrombin inhibitor) which when taken with alcohol may cause bleeding. Alcohol, SJW, and supplements are thus avoided.

Rivaroxaban, apixavan

Vitamin E, SJW, Grapefruit should be avoided with intake of this anticoagulant drug (Factor Xa Inhibitor)

Aspirin/Salicylate

An antiplatelet drug which displaces folate, iron, sodium, potassium, and vitamin C, especially with long term use.

Clopidogrel

An antiplatelet drug which should not be taken with grapefruit/related citrus

Metformin

An insulin sensitizing agent which may impair B12 and folate absorption. Alcohol is avoided due to risk of lactic acidosis. It does not cause hypoglycemia

Rosiglitizone

An insulin sensitizing agent (TZD) which may cause weight gain. This specific drug may additionally increase total chol, LDL, TGs, while decreasing HDL

Pioglitizone

An insulin sensitizing agent (TZD) which may cause weight gain. This specific drug may additionally decrease total chol, LDL, TGs, while increasing HDL

Sulfonylureas (gl - ide)

An insulin stimulating drug for DM management which may cause hypoglycmia, weigh gain, GI distress, and altered appetite

Repaglinide

An insulin stimulating drug which leads to weight gain, GI distress with vomitting. May also cause hypoglycemia

Alpha-glucosidase inhibitors

Drugs which delay the absorption of dietary disaccharides and complex carbohydrates. Often, they may cause GI distress

Miglitol

An a-glucosidase inhibitor which impairs iron absorption

Dipeptidyl Peptidase-4 Inhibitor (Glipitins)

An enzyme inhibitor drug for hyperglycemics which may cause weight gain and GI distress

Gliflozins

A class of glucose reabsorption inhibitor which causes lower reabsorption and hugher urinary loss of glucose. It may lead to weight loss, polydypsia, hypovolemia, and dehydration

Corticosteroids (-predni-)

A steroid drug which induced protein catabolism, causing wasting, bone atrophy. It also promotes urinary loss of minerals, vitamin C, and nitrogen. Furthermore, it causes sodium retention

Bisphosphonates ("dronates")

A steroid drug which lowers serum calcium and may cause zinc deficiency in the long run.

Loop diuretics

Drugs that increase urinacry excretion of Na, K, Mg, and Ca. With long term use it may lead to increased urinary zinc excretion

furosemide, bumetanide

Loop diuretic drugs

Thiazide diuretics hydrochlorothiazide

Drugs that increase urinacry excretion of Na, K, Mg, and increase renal absorption of Ca. With long term use it may lead to increased urinary zinc excretion

Hydrochlorothiazide (HCTZ)

thiazide diuretic

Potassium sparing diuretics

Drugs that increase renal reabsorption of potassium but can lead to increased urinary zinc excretion in the long run

Triamterene, spironolactone

Potassium sparing diuretics

Acetaminophen (Tylenol)

Non-narcotic analgesic which with chronic (excessive) alcohol intake may increase the risk for hepatotoxicity

NSAIDs

Analgesic class of drugs which may increase risk of GI bleeding and cardiovascular events. Must be taken with food or milk to prevent toxicity or irritation.

Opioid Analgesics

Highly addictive analgesic drugs which causes slowing down of digestion

Celexocib

An analgesic (cox-2 inhibitor) which when taken with high fat meals becomes more absorbed

SSRIs (selective serotonin reuptake inhibitors)

A type of antidepressant medication which may increase/decrease weight. Tryptophan is avoided to avoid serotonin syndrome

Amytryptyline

An antidepressant which may increase appetite especially for sweets and cause weight gain. High fiber foods reduce its absorption

Phenelzine (MAO inhibitor)

An antidepressant which may increase appetite especially for sweets and cause weight gain. Risk of severe reaction occurs with dietary tyramine

Lithium

An antidepressant/mood stabilizer. it is affected by sodiun intake. May cause dehydration, thirst, and dry mouth.

Carbamazepine

Anticonvulstant which may decrease biotin, folic acid, and vitamin D levels. May cause reduction in bone mineral density with long term use

Phenytoin

Anticonvulstant which may decrease serum folic acid, calcium, vitamin D levels, biotin, and thiamine. Alcohol intake disrupts function while Ca and Mg prevents absorption.

Phenobarbital

Anticonvulstant which induces rapid metabolism of vitamin D while decreasing vitamin K metabolism. It decrease serum folic acid and B12

GABA analogues ("gaba")

An anticonvulstant which is affected by Mg in terms of drug absorption.

Memantine

A anti-dementia drug which is less exreted when urinary pH > 8, thus alkaline foods are avoided.

H2 Receptor Antagonist

GI drugs which interferes with vitamin B12 and iron absorption

Ranitidine, famotidine

H2 receptor antagonist

Proton pump inhibitors ("prazoles")

GI drugs which, in the long run, inhibit iron and B12 absorption. Calcium absorption also affected. Low Mg may also occur. C. difficile may also develop.

Metoclopramide

A GI drug which increases GI emptying and may change insulin requirements in diabetic patients

Methotrexate (folate antagonist)

Antineoplastic drug which decreases level of active folate. Folate supplememnts presrcibed for antirheumatic but not for antineoplastic purposes.

Cyclophosphamide (alkylating agent)

Antineoplastic drug with metabolites which causes bladder irritation, thus high fluid intake is recommended

Carbidopa/levidopa

Anti-parkinson's drug which serves as dopamin precursors. Pyridoxine supplements are regulated to control pyridoxine-enhanced peripheral decarboxylation

Selegiline (MAO-B inhibitor)

Antiparkinson's drug which selectively inhibits MAO-B, thus tyramine containing foods are avoided.

Entacopone

Antiparkinson's drug (COMT inhibitor) which chelates with iron thus, for some, decrease serum zinc and make drug less effective

Dextroamphetamine and amphetamine

CNS stimulants for ADHD treatment which, when with high dose vitamin C and acidifying foods, may be less absorbed and more excreted