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Medications in Disease
Treatment
Medications used to prevent & treat health
problems
Herbal supplements often used as
alternative therapy
Any ingested chemical can affect
metabolism & produce adverse effects
Drug-drug interactions
Diet-drug interactions
Medications in Disease
Treatment (cont)
Prescription drugs
Over-the-counter drugs
Generic drugs
Medications in Disease
Treatment (cont)
Risks from
medications
Any drug carries some
risk of adverse reaction
Drug considered safe
when benefits of use
outweigh potential risks
Risks greater when
incorrectly used
(prescribed &/or
administered)
Potential Risks
Side effects
Drug-drug interactions
Diet-drug interactions
Medication errors-see
Table 15-1, Inappropriate
Abbrev., p.440
Medications in Disease
Treatment (cont)
Elderly people using multiple
meds are especially
susceptible to adverse effects
Medications in Disease
Treatment (cont)
Reducing risk
Patient counseling & education
Discussion of lifestyle or dietary practices as
alternatives to drug therapy
Assessment of all medications, including
prescription, OTC & dietary supplements
Monitoring side effects
Assessment of patient understanding of
medication use, interactions & drug safety
Herbal Supplements
Widely used by consumers
to improve general health
& prevent or treat specific
illnesses
Do not require FDA
approval before marketing
FDA must show that herbal
supplement is unsafe
before it can be removed
from marketplace (ex.
ephedrine)
Manufacturers &
distributors are responsible
for determining safety
Not required to provide
evidence
FDA notification of illness
or injury related to use of
product is not required
Diet-Drug Interactions
Diet-drug interactions fall into the following
categories:
Medications can alter food intake by suppressing
appetite or causing complications that interfere with
food intake
Medications can alter absorption, metabolism &
excretion of nutrients
Nutrients & other food components can alter
absorption, metabolism & excretion of medications
Some interactions between food components &
medications can be toxic
Diet-Drug Interactions
(cont)
Drug Effects on Food Intake
Reduce food intake through
Diet-Drug Interactions
(cont)
To prevent diet-drug
interactions, find out about all
Drug effects on nutrient absorption
the drugs & supplements a
Damage of intestinal mucosa:
patient takes
most widespread cause of problems
Drug-nutrient binding:
Direct inhibition:
Diet-Drug Interactions
(cont)
Dietary effects on drug absorption
Stomach emptying rate: taking medications on empty
stomach tends to increase absorption rate; taking
medications on full stomach may delay its absorption rate
(ex. Aspirin)
Stomach acidity: absorption rates affected by acid or
alkaline medium
Interactions with food components: may bind with drugs &
inhibit absorption
Diet-Drug Interactions
(cont)
Dietary effects on drug metabolism
Diet-Drug Interactions
(cont)
Dietary effects on drug excretion
Alterations in excretion causing toxicity or reduced
effectiveness of the drug
Increased or decreased reabsorption (ex. Li and Na)
Alterations in drug actions
Nutrition in Practice
Complementary & Alternative
Therapies
Nutrition in Practice
Complementary & Alternative
Therapies
Role of health practioner
Identify & communicate with patients who are
using CAM
Educate patients regarding hazards of
postponing or discontinuing conventional
therapy
Educate patients regarding possible
interactions & adverse reactions
Identify ways to integrate CAM & conventional
treatment
Practitioner needs to regularly update knowledge
of alternative therapies in order to knowledgably
discuss options with patients
Nutrition & Diet Therapy (7th Edition)