W10 - Nutrient Interactions

Question 1

What can medication do to nutrient absorption?

Answer 1

⬇️ or prevent it

Question 2

What is a chelation reaction?

Answer 2

Metal ion + organic complexing agent –> Ring structure encompassing the metal ion + removes it.

Question 3

What do chelation reactions between medications + minerals (metal ions) do?

What is the advice that follows this?

Answer 3

⬇️ amount of mineral avail. for absorption.

Advice - Take minerals at least 2 to 6 hrs apart from drug.

Question 4

What is adsorption?

Answer 4

Adhesion of atoms, ions or mol from a gas, liquid or dissolved solid to a surface.

Creates a film of the adsorbate on the surface of the adsorbent.

Question 5

What is absorption?

Answer 5

Fluid (absorbate) is dissolved by or permeates a liquid or solid (absorbent).

Question 6

What can adsorption do to nutrient absorption?

Answer 6

⬇️ it

Question 7

What drug is known to treat diarrhoea?

Answer 7

Bile acid sequestrant cholestyramine (Questran)

Question 8

What does Bile acid sequestrant cholestyramine (Questran) do?

Answer 8

ADSORBS fat-sol vitamins A,D,E+K.

Question 9

What does it mean that Bile acid sequestrant cholestyramine (Questran) adsorbs A,D,E+K?

Answer 9

Should recommend vitamin supplementation w/ LT use of this drug, especially when taken more than once a day.

Question 10

Bile acid sequestrant cholestyramine (Questran)

What vitamin supplementation is recommended?

Answer 10

30ml + of mineral oil/ day

= ⬇️ absorption of vit A,D,E+K

It is advised to take the mineral oil a.m + vitamins 2+hrs later.

Question 11

How can drugs reduce nutrient absorption?

Answer 11

By influencing transit time of food + nutrients in gut.

Question 12

What reduce transit time of food + nutrients in the gut?

Answer 12

Cathartic agents + laxatives

Question 13

What can cathartic agents + laxatives cause?

What can this then lead to?

Answer 13

Diarrhoea

Loss of Ca2+ + K+.

Question 14

What else can diarrhoea be induced by?

Answer 14

Drugs containing sorbitol, i.e syrup or solution forms of furosemide.

Drugs that ⬆️ peristalsis, i.e Cytotec.

Question 15

How might a drug prevent nutrient absorption?

Answer 15

By changing the GI env.

Question 16

What might antisecretory drugs be used to treat?

Answer 16

Ulcer disease + GERD.

Question 17

How do antisecretory drugs treat Ulcer disease + GERD?

Answer 17

Inhibit gastric acid secretion + ⬆️ gastric pH.

== Impairs absorption of V B12 by ⬇️ cleavage from its dietary sources.

Question 18

What do the drugs do that have the biggest effect on nutrient ABSORPTION?

Answer 18

Those that damage the intestinal mucosa.

Question 19

Damage to the intestinal mucosa

Answer 19

Damage to the structure o the villi + microvilli inhibit the brush-border enzymes + intestinal transport systems involved in nutrient absorption.

Question 20

What does damage to the gut mucosa commonly result from?

Answer 20

Nonsteroidal anti-inflammatory drugs (NSAIDs)

LT antibiotic therapy

Question 21

What is the science of nutrigenomics?

Answer 21

Science of nutrients + the genes.

How naturally occurring chemicals in foods can alter mol expression of genetic info in each ind.

Question 22

What does nutrient intake affect?

Answer 22

Genomics

Proteomics

Metabolomics

== Then impacting disease prevention + +ive health outcomes.

Question 23

What is genomics

Answer 23

Make up of genes + the gene expression

Question 24

What is proteomics

Answer 24

Creation of the gene

Question 25

What are the 3 nutrient-gene interactions?

Answer 25

Direct interactions Epigenetic interactions Genetic variations

Question 26

NUTRIENT-GENE INTERACTIONS Direct interactions

Answer 26

Sometimes after interacting w. a receptor, nutrients behave as transcription factors meaning they can bind to DNA + acutely induce gene expression.

Question 27

NUTRIENT-GENE INTERACTIONS Epigenetic interactions

Answer 27

Nutrients can alter the structure of DNA so that gene expression is chronically altered.

Question 28

NUTRIENT-GENE INTERACTIONS Genetic variationsT

Answer 28

Common genetic variations i.e single-nucleotide polymorphisms (SNPs) can alter the expression of functionality of genes.

Question 29

What is meant by genetic expression?

Answer 29

Transcription Translation Post-transcriptional + translation modification == End product = Proteins

Question 30

What are nutraceuticals?

Answer 30

Products for nutrition + medicine.

Question 31

What may nutraceuticals be used for?

Answer 31

Improve health Delay ageing process Prevent chronic diseases Support structure/function of the human body

Question 32

According to Nasri et al. 2014, what is the frequency use of nutraceuticals in developed countries?

Answer 32

50-70%

Question 33

What is pharmacokinetics?

Answer 33

Absorption, distribution, metabolism and excretion of drugs.

Question 34

What can drug nutrient interactions (DNI) do?

Answer 34

Alter the effectiveness of a drug Cause a nutrient depletion

Question 35

How can a DNI cause a nutrient depletion?

Answer 35

By disruption absorption ⬆️ excretion of 1 or more nutrients

Question 36

What are the increased risks of a DNI?

Answer 36

Older adults Those who take multiple medications (poly pharmacy) Those taking medications w/ dietary supplements

Question 37

In what ways can drugs influence the bodys nutritional status?

Answer 37

Ingestion (via appetite or taste) Secretion (via oral secretion + gastric acid secretion) Absorption (via GI transporters or GI drug metabolising enzymes) GI motility GI flora (immunity) Nutrient metabolism Nutrient excretion

Question 38

What are the nutrient related side effects of medication?

Answer 38

GI distress Blood sugar imbalance Appetite changes Weight gain/loss Organ toxicity

Question 39

What can be the most prominent examples of a specific pharmacokinetic food-drug effect interaction?

Answer 39

Grapefruit juice + Felodipine

Question 40

What can be the most prominent examples of a specific pharmacokinetic food-drug effect interaction? Grapefruit juice + Felodipine What can the interaction result in?

Answer 40

Inhibition of CYP3A4 metabolism Inhibition of uptake + efflux membrane transporters.

Question 41

Recommendations regarding DNI

Answer 41

Avoidance of certain foods w/ many drugs i.e grapefruit Change timing of foods around taking drugs Screen patients routinely for supplement + herbal use