Transcript Nursing Care Everything an LPN/LVN Needs to Know and Do

Focus on
Pharmacology
Essentials for Health
Professionals
Jahangir Moini, MD, MPH
Chapter 8
Nutritional Aspects of Pharmacology
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Nutrition
• Nutrition: how the body takes in and uses
food and other sources of nutrients for
growth and repair of tissues
• A five-part process: intake, digestion,
absorption, metabolism, elimination
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Nutrients
• Nutrient: element or compound from diet
that supports normal metabolism, growth,
reproduction, or other functions
– Essential nutrient: needed by body for
normal functioning
– Nonessential nutrient: can be synthesized by
body from other compounds; may also be
derived from diet
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Seven Nutrients
•
•
•
•
•
•
•
Proteins
Fatty acids (also called lipids or fats)
Carbohydrates
Fiber
Vitamins
Minerals
Water
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Macronutrients
• Needed by body in large amounts for
energy
– Carbohydrates
– Fats
– Proteins
– Macrominerals (dietary minerals needed in
high quantities: grams)
– Water
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Macronutrients Are Energy
• Macronutrients: interchangeable as
sources of energy
– Fats yield 9 kilocalories of energy per 1 g
consumed (9 kcal/g)
– Proteins and carbohydrates yield 4 kcal/g
• Water requirements: 1 mL/kcal of energy
expended or about 2,500 mL/day
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Essential Amino Acids
• Components of proteins that cannot be
synthesized by the body and must be
provided by diet
• Nine of the 20 amino acids are essential
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Essential Fatty Acids
• Required in amounts equaling 6% to 10%
of fat intake (5–10 g/day)
• Appear to play a role in decreasing
triglyceride levels and the growth rate of
atherosclerotic plaque
• Required for the formation of
prostaglandins and thromboxanes
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Types of Fatty Acids
• Saturated
– Dense, heavy, and solid at room
temperature
– Found in dairy products and meats
• Unsaturated
– Usually liquid at room temperature
– From vegetables and legumes: corn, soy,
peanuts, safflower
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cholesterol
• A natural lipid found in cell membranes
• Found in highest concentrations in
animal muscles and organs
• Essential for certain cell structures
• Excess cholesterol can form
atherosclerotic plaque, leading to
cardiovascular disease
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Carbohydrates
• Provide about two thirds of daily energy
needs
• Aid in fat metabolism and help reserve
protein for uses such as repairing and
building tissues
• Daily requirement 50% to 60% of total
caloric intake
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Two Types of Carbohydrates
• Simple sugars
– Quickly absorbed
– Found in fruits, some vegetables, milk, and
table sugar
• Complex carbohydrates
– Must be processed by the body before
absorption
– Found in grain, fruits, and vegetables
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Storage of Carbohydrates
• Glucose (a sugar) is stored in the liver
and muscles as glycogen (starch).
– Available to supplement dietary supplies of
carbohydrates
• Excess amounts of carbohydrates are
stored in the body as adipose tissue (fat).
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Blood Glucose Levels
The central nervous system (CNS)
requires a constant supply of glucose to
function properly. Sustained low blood
glucose levels, which can be caused by
an excessively low intake of
carbohydrates, can result in brain
damage and death.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Lactose Sensitivity
• Lactose is a sugar in human and animal
milk that must be broken down by the
enzyme lactase to be digested.
• Many infants and children have trouble
digesting foods that contain lactose.
• Lactose-free milk can be substituted.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Fiber: A Complex Carbohydrate
• Soluble fiber: absorbs water and swells
when eaten; found in oats, fruits, and
vegetables
• Insoluble fiber: not absorbed by body;
found in bran of whole wheat and brown
rice
• Provides stool bulk, which stimulates
peristalsis
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Micronutrients
• Vitamins and essential trace nutrients
needed in very small quantities
• Insufficiencies cause biochemical
alterations (such as changes in the
structure and function of tissues and
organs) and diseases
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamins
• Organic compounds needed for normal
human growth, development, and
maintenance of normal body function
• Classified by solubility
– Water soluble: B and C vitamins
– Fat soluble: A, D, E, and K vitamins
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Thiamine (B1)
• Sources: whole grains (especially wheat
germ), lean meats, fish, soybeans, and
other beans
• Important in carbohydrate metabolic
processes
• Deficiency leads to beri-beri (edema,
cardiovascular abnormalities, and
neurologic symptoms)
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Riboflavin (B2)
• Sources: dairy, yeast, and liver
• Important in metabolism of fats,
carbohydrates, and proteins
• Deficiency causes cheilosis, stomatitis,
glossitis, and seborrheic dermatitis
• No danger of excessive consumption
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Nicotinamide (B3)
• Also called niacin
• Sources: liver, yeast products, peanuts,
whole grain cereals, and fish
• Large doses lower cholesterol,
triglycerides, free fatty acids
• Deficiency causes pellagra (dementia,
dermatitis, diarrhea, and death)
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Nicotinamide (B3)
(continued)
• Toxicity includes hepatic impairment,
severe hypotension, and various skin
conditions
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pharmacologic Doses
of Niacin
• At high doses, niacin decreases blood
levels of low-density lipoprotein (LDL)
cholesterol and triglyceride levels, which
are linked to cardiovascular disease, and
increases high-density lipoprotein levels
(good cholesterol).
• Niacin is used under physician’s
supervision for this purpose.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins:
Pantothenic Acid (B5)
• Sources: whole grain cereals, legumes,
meat, eggs
• Needed for formation of coenzyme A
• Deficiency is rare
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Pyridoxine (B6)
• Sources: animal and plant products
• Used to prevent neuritis in patients on
isoniazid (INH) therapy and to treat
hyperemesis gravidarum (nausea during
pregnancy)
• Deficiency is rare
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Biotin
• Sources: widely available in foods and
made by natural flora in intestines
• Deficiency is almost unknown
• No known toxicities
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Folate
• Sources: dark green, leafy vegetables
• Aids creation of DNA; essential to
hemoglobin formation and amino acid
synthesis
• Deficiency causes anemia
• Increased folic acid recommended in
pregnancy to prevent spina bifida
• No known toxicity
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
B Vitamins: Cobalamin (B12)
• Sources: fish, dairy, organ meats, eggs
• Promotes normal cell function, especially
blood formation and nerve cell function
• Lack of intrinsic factor in GI tract (caused by
certain GI disorders) can block absorption of
B12, leading to pernicious anemia
– More common in elderly patients
• No known toxicity
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B Factors (Choline)
• Sources: milk, eggs, liver, and peanuts
• Needed to produce acetylcholine
(neurotransmitter involved in memory
and muscle control)
• Deficiency linked to Huntington’s chorea,
Parkinson’s disease, and Alzheimer’s
disease
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin B Factors (Choline)
(continued)
• Excess doses may lower blood pressure;
cause fishy body odor, sweating, and
excessive salivation; and reduce growth
rate
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin C: Ascorbic Acid
• Sources: capsicums, guavas, kiwi, citrus
• Aids wound healing, tissue repair,
infection resistance, iron bioavailability,
and calcium absorption
• Antioxidant role: may reduce cancer risk
and lower cholesterol levels
• Deficiency causes scurvy
• Excess may cause diarrhea and gastritis
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin C and Cataracts
• Vitamin C may protect against cataracts
because the body concentrates it in the
lenses of the eye.
• The use of vitamin C for 10 or more
years is associated with 77 to 83% lower
prevalence of early to moderate
cataracts.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Fat-Soluble Vitamins
•
•
•
•
•
•
Vitamin A (retinol)
Vitamin D3 (cholecalciferol)
Vitamin D2 (ergocalciferol)
Vitamin E (alpha tocopherol)
Vitamin K1 (phylloquinone)
Vitamin K2 (menaquinone)
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Retinol (Vitamin A)
• Sources: fish-liver oils, butter, egg yolk,
liver
– All milk is fortified with vitamin A
– Carotene is converted to vitamin A in
body
• Aids tissue maintenance, skeletal and
soft-tissue growth, protein synthesis,
vision
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Retinol (Vitamin A) (continued)
• Mild deficiency may cause night
blindness
• Toxicity (hypervitaminosis A) marked by
hair loss, jaundice, joint pain, liver injury,
ascites
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin A Deficiency
Dietary vitamin A deficiency in the
number one cause of blindness in
children worldwide.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Overconsumption of
Vitamins or Minerals
• If overconsumption of vitamin or mineral
occurs, patients should cut back, but not
stop immediately, to allow the body to
adjust.
• Stopping immediately can trigger a
deficiency.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cholecalciferol (Vitamin D3)
• Sources: yeast, fish-liver oils
• Cholecalciferol (vitamin D3), made by the
body in response to UV light; then
activated by cholesterol to become
calcitriol
• Stimulates calcium and phosphorus
absorption
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Cholecalciferol (Vitamin D3)
(continued)
• Deficiency causes rickets, osteomalacia,
osteoporosis
• Toxicity can occur, especially in children
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Tocopherol (Vitamin E)
• Sources: vegetable oils, nuts, fortified
cereals
• Protects breakdown of red blood cells
(RBCs) Deficiency can occur in
premature infants who miss final 1-2
months of gestation
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Tocopherol (Vitamin E) (continued)
• Deficiency in adults disrupts myelin
production, affecting physical activity and
vision
• Excess intake may interfere with vitamin
K and blood clotting
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin K
• Phylloquinone (K1) is dietary form;
menaquinone (K2) is synthesized by
intestinal bacteria
• Sources: green leafy vegetables
• Aids blood clotting and bone development
• Antidote for overdose of anticoagulants
• Deficiency is rare
• No known toxicity
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitamin K
• Phylloquinone is routinely given to
newborns to prevent hemorrhage when
the umbilical cord is cut.
• Trade names of this “vitamin K shot” are
AquaMephyton, Mephyton, or
Phytonadione.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Mineral and Vitamin
Interactions
• Insufficient vitamin D intake hinders the
uptake of calcium.
• High amounts of supplemental vitamin C
reduce copper levels.
• Vitamin C can increase iron absorption
as much as 30%.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Mineral and Vitamin
Interactions (continued)
• Excessive amounts of vitamin E interfere
with iron absorption.
• Vitamin B6 is required to metabolize
magnesium and zinc.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Proper Dosage of Vitamins
• Advise patients about the proper dose of
vitamins that are needed to maintain
metabolic control and prevent disease.
• Warn patients that certain health
problems are related to inadequate or
excessive intake.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Minerals
• Major: daily requirements more than
100 mg/day
– Calcium, phosphorus, sodium, potassium,
magnesium, and chlorine
• Minor (essential trade minerals): daily
requirements less than 100 mg/day
– Iron, iodine, fluoride, zinc, chromium,
selenium, manganese, molybdenum, and
copper
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Calcium
• Sources: milk, cheese, salmon, green
leafy vegetables, whole grains
• Aids bone formation, nerve conduction,
myocardial and skeletal muscle
contractions
• Absorption dependent on vitamin D
• Deficiency causes rickets, osteomalacia,
osteoporosis
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Calcium (continued)
• Excess may cause constipation, nausea,
hypotension, vomiting, kidney stones,
cardiac arrhythmias
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Phosphorus
• Sources: milk, cheese, legumes, beef, fish,
pork
• Needed for bone and tooth formation,
energy, storage of fats, metabolism of other
nutrients
• Deficiency can cause anemia, bone
brittleness, confusion, and weakness
• Toxicity may cause hypocalcemia and
kidney stones
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Sodium
• Source: table salt
• Needed for body fluid balance and acid–
base balance; regulates nerve transmission
and cell membrane irritability
• Deficiency may cause headache, confusion,
nausea, weakness, anxiety, muscle
spasms, hypotension
• Toxicity produces hypertension and edema
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Potassium
• Sources: oranges, bananas, red meats,
vegetables, yams, milk products, coffee
• Helps maintain normal cardiac and muscle
function
• Deficiency can cause weakness, paralysis,
cardiac arrhythmias, digitalis toxicity
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Potassium (continued)
• Excessive intake may produce muscle
weakness, diarrhea, severe dehydration,
abdominal pain, hypotension, cardiac
arrest
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Chlorine
• Sources: table salt, meat, milk,
processed foods
• Major electrolyte that aids acid–base
balance and fluid balance
• Deficiency is rare
• No known toxicity
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Iron
• Sources: meat, eggs, vegetables, cereals
• Aids in synthesis of hemoglobin and
general metabolism
• Deficiency causes anemia
• Toxicity can be fatal
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Iron Toxicity
• In the United States, iron overdose from
supplements is leading cause of
poisoning in young children.
• Symptoms: nausea, vomiting, diarrhea
• If not treated immediately, can result in
brain, kidney, liver, and heart damage
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Iodine
• Sources: iodized table salt, seafood
• Helps synthesize thyroxine to control
body’s basal metabolic rate
• Deficiency can cause goiter, cretinism,
and myxedema
• Excess intake cause acne-like skin
lesions or worsen acne
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Cretinism
• Cretinism occurs in children born to
mothers who had limited iodine intake
during adolescence and pregnancy.
• Children with cretinism have retarded
physical and mental development.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Zinc
• Source: meat
• Important during growth periods
• Deficiency may cause retarded physical
growth (such as dwarfism) and retarded
sexual maturation, poor wound healing,
hair loss, diarrhea, skin irritation
• Excess intake can inhibit copper
absorption or cause nausea, vomiting,
and decreased immune function
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Fluoride
• Sources: fish, tea
• Prevents dental caries by strengthening
tooth’s ability to withstand bacterial
erosion
Focus on Pharmacology, First Edition
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Upper Saddle River, New Jersey 07458
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Copper
• Sources: organ meats (liver), seafood,
nuts, seeds, legumes, grains
• Aid energy production and hemoglobin
synthesis
• Deficiency is rare; increased intake is
recommended for pregnant or lactating
women to meet increased needs
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Copper (continued)
• Toxicity: Wilson’s disease is genetic
disorder causing excess storage of copper
in body that can result in liver and nerve
damage
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Nutritional Requirements
• Nutritional needs of infants in 1st year of
life are increased.
• Breast milk and commercially prepared
formula contain the correct balance of
nutrients.
• Cow’s milk does not meet these
standards.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Nutritional Requirements
• Food and Nutrition Board issues
recommended dietary allowances (RDAs)
every 5 years
• Body composition requires balancing
energy intake with energy expenditure
• Nutrition during pregnancy: 25–30 pound
weight gain recommended
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Cachexia
• A profound syndrome caused by
malnutrition and a disturbance in glucose
and fat metabolism.
• Occurs in patients with terminal cancer or
AIDS and in patients who are in generally
poor health.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Nutritional Support
• Enteral nutrition: used in patients with a
functioning GI tract to supplement or
completely replace oral feeding;
administered through a tube
• Parenteral nutrition: indicated for patients
who require intensive protein and caloric
support and who are unable or unwilling to
take oral supplementation; administered IV
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Nutrient–Drug Interactions
• Food affects drug absorption by slowing
gastric emptying, by binding with a drug,
decreasing the access of drugs to sites of
absorption, altering the dissolution rate of
drugs, or altering the pH of the GI contents.
• Drugs can affect mineral and vitamin
metabolism and absorption and suppress
appetite.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Food Additives
and Contaminants
• Benefits of additives
– Facilitate food processing and preservation
– Enhance restorative or stimulating properties
of foods
– Control natural contaminants
• Additives are strictly regulated.
• Reported health problems related to
additives have been trivial and largely
anecdotal.
Focus on Pharmacology, First Edition
By Jahangir Moini
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.