Aging, Pharmacology and Nutrition

Published on June 4, 2012 by

Long-term medication therapy is common, allowing increasing numbers of people to control chronic illnesses and achieve improved quality of life. However, use of medications is rarely without side effect of risk, making prevention and management of medication complications more challenging. As individuals with chronic illness age, it is more common to encounter multiple medications directed at multiple organ systems, compounding the challenge of managing the adverse effects of, and interactions among, multiple medications. Drug-nutrient interactions and nutritional deficiencies are a potential primary problem with many medications which can affect primarily the oral environment and have secondary nutritional and diet consequences.
Drug-induced nutritional deficiencies may develop through various mechanisms, occurring through different physiologic pathways. Drugs can interfere with synthesis of nutrients and alter the ability to transport, store, and metabolize nutrients. Nutrient depletion can result either by preventing nutrient absorption, enhancing nutrient elimination, or both. Drugs, even in therapeutic doses, can interfere with nutrient utilization, especially when the intake of nutrients is less than the demand or when nutrient stores are depleted. Vitamin and mineral deficienies can result from poor nutrient absorption caused by binding of nutrients to drugs, increased excretion, or impaired utilization. The inhibition of gastrointestinal (GI) absorption of vitamins by cholestryramine; the enhancement of potassium, magnesium, and zinc depletion by thiazide diuretics; and the acceleration of vitamin D metabolism and calcium depletion by anticonvulsants such as phenytoin and phenobarbital are well-documented examples.
Drugs can produce damage to the exocrine pancreas, causing decreased production or release of pancreatic enzymes, which leads to decreased digestion of fat, protein, and starch. Some drugs decrease the absorption of macronutrients incluing sugars, fats, amino acids, vitamins, and minerals, causing nutritional deficiencies depending on the relative absorptive capacity of the small intestine. Drugs can additionally have a direct depressant or stimulating effect on appetite and food intake.

Filed under: Nutrition

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