Nutritional Pharmacology

Question 1

List 3 over-the-counter analgesic medications

Answer 1

Paracetamol

Aspirin

Ibuprofen

Question 2

A diet rich in which mineral should be avoided by people taking ACE Inhibitors?

Answer 2

Potassium

Question 3

What are the stages of pharmacokinetics?

Answer 3

Absorption

Distribution

Metabolism

Excretion

A Distant Memory Excreted

Question 4

The use of which drug can lead to rhabdomyolysis — the breakdown of muscle cells?

Answer 4

Statins

Question 5

Grapefruit juice is best known to inhibit the…

Answer 5

CYP3A4 enzyme in the intestinal wall

Question 6

Which drug can contribute to increased urinary loss of calcium?

Answer 6

Thyroxine

Question 7

Which drug is associated with a number of long-term side effects such as bone fractures, hypomagnesaemia (low blood magnesium), vitamin B12 deficiency and dementia?

Answer 7

Proton Pump Inhibitors

Question 8

Which two supplements must be avoided when taking selective serotonin re-uptake inhibitors to avoid the risk of serotonin syndrome?

Answer 8

St. John’s wort

5-HTP

Question 9

The main location of drug metabolism is:

Answer 9

The liver

Question 10

In the liver, drugs are chemically altered by which enzyme family?

Answer 10

Cytochrome P450

Question 11

3 conditions where NSAIDs are contraindicated in

Answer 11

Peptic ulceration

History of gastrointestinal bleeding

Hypersensitivity to aspirin

Question 12

3 alternative approaches to corticosteroids

Answer 12

Ginger

Turmeric

Quercetin

Question 13

Pharmacodynamics is the study of how drugs interact with the body to exert their effects. Give 3 factors affecting a drug’s mode of action…

Answer 13

Genetic mutations

Malnutrition

Advancing age

Question 14

Malabsorption of vitamin B12 and folate is commonly associated with which of the following drugs?

Answer 14

Metformin

Question 15

Ingestion of soy foods simultaneously with thyroid hormones can cause what?

Answer 15

Decrease thyroid hormone absorption

Question 16

Why are leafy vegetables contraindicated in higher quantities for clients taking Warfarin?

Answer 16

They contain indoles which increase the metabolism of warfarin, and also contain vitamin K, which reduces the anti-clotting effects of warfarin.

Question 17

Give 3 diet and lifestyle changes recommended to a client instead of them using antacids…

Answer 17

Chew food well

Stop smoking

Avoid caffeine

Question 18

Which type of drugs have the greatest absorption?

Answer 18

Absorption is greatest for lipid-soluble and small molecule drugs

Question 19

What is the mode of action of Diuretics?

Answer 19

Inhibit reabsorption of filtrate from various sections of the nephron, decreasing blood volume and pressure.

Question 20

3 examples of topical drug administration?

Answer 20

Inhalation

Patches

Ear and eye drops

Question 21

Why do NTs need to know about pharmacology?

Question 22

What do drugs contain?

Question 23

Compare the use of willow bark and asprin

Question 24

What is meant by ADME?

Question 25

Explain how the cytochrome P450 system affects drugs

Answer 25

Via Phase 1 liver metabolism of the drug

Question 26

2 factors that can affect the absorption of a drug

Question 27

2 factors that can affect the Distribution of a drug

Question 28

2 factors that can affect thre metabolism of a drug

Question 29

2 factors that can affect the excretion of a drug

Question 30

7 e.g.s of longer-term side effects with drugs that are know to cause these side effects

Question 31

Give 1 long-term side effect of taking 1. Diclofenac 2. NSAIDs 3. Omeprazole 4. Metformin

Question 32

List 4 side effects of taking PPIs

Question 33

If a client is on an anticoagulant, which nutrients should you avoid or use with caution?

Answer 33

Ginkgo Green vegetables Soy (Warfarin) Garlic (potentially)

Question 34

Garlic 1. Interactions 2. Mechanisms 3. Theoretical interaction?

Answer 34

1. Statins and blood pressure drugs 2. Additive effect on statins and beta blockers 3. Anticoagulants and antiplatelet drugs

Question 35

Ginkgo 1. Interactions 2. Mechanisms 3. Drugs to monitor and why

Answer 35

1. Antiplatelet and anticoagulant drugs 2. It's a potent anticoagulent - additive 3. Benzos, anti-epileptic, anti-psychotic, diabetic, HIV, omeprazle - CYP enzymes induction

Question 36

Grapefruit 1. Interactions 2. Mechanisms 3. Another nutrients that has a similar interaction mechanism

Answer 36

1. CYP3A4 drugs (e.g. digoxin, statins) 2. It inhitits the CYP 3A4 enzymes in the intestinal wall 3. Pomegranate

Question 37

Green Veg 1. Interactions 2. Mechanisms

Answer 37

1. Anticoagulants e.g. Warfarin 2. Contains indoles that increase Warfarin metabolism and contains Vit K that increases clotting therefore making the drug less effective

Question 38

Soy 1. Interactions

Answer 38

1. Levothyroxine (reduces absorption) Tamoxifen (Isoflavones)

Question 39

Dairy/Calcium 1. Interactions 2. Mechanisms 3. Recommendation?

Answer 39

1. Antibiotics e.g. quinolones and tetracycline Bisphosphonates (for osteoporosis Levothyroxine 2. Binds to the drugs - reduces absorption 3. Take 4 hours apart

Question 40

What serious complication is linked to Diclofenac?

Answer 40

Cardiovascular disease

Question 41

What does NTI stand for and give 3 examples

Answer 41

Narrow Therapeutic Index drugs - Warfarin - Digoxin - Lithium

Question 42

3 changes to diet that can affect medication and why

Answer 42

1. High protein diet - decreases intestinal absorption of L-dopa and affects the drug crossing the blood brain barrier 2. High fibre diets - can reduce levels of trycyclic antidepressants (decreases intestinal absorption) 3. Salt restriction - can increase lithium to toxic levels (Na involved in active transport of lithium)