Diet-treatment interactions

10 important questions on Diet-treatment interactions

What are the key elements when talking about diet-treatment interactions

  • Nutrition determines treatment outcomes, also by modulating drug (side-) effects
  • Vice versa, treatment can affect nutritional status
  • Various mechanisms can be involved
  • Prediction is not always easy: unexpected outcomes often occur

What are the effects of gastric emptying

  • Delayed emptying may slow down of absorption
  • The total amount (finally) absorbed may differ and depend amongst others on
    • acid stability
    • dissolution rate

What are the issues of diet-treatment interactions

  • Food - drug interactions basics
  • Don's take these drugs with ...
  • Effects of cancer chemotherapy on nutrient intake and kinetics
  • Body composition and drug effects and vice versa...
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Interactions prior to administration

  • Gastric emptying, residence time and pH effects
  • Drug distribution and elimination
  • Binding, decomposition in the GI tract

Effects of food (and food-supplements) on drug action  (2)

  • Pharmacokinetic interactions (changes in ADME)
  • Pharmacodynamic interactions

Processes determining oral bioavailability

Dissolution, binding, metabolism etc. > Intake intestinal tract (barrier + metabolism) > Liver > Systemic circulation

What are the effects of high and low fat meal on Lapatinib

Needs to be taken with a high fat meal

take lapatinib at least 1hr before or 1 hr after a meal. Take it the same moment relative to your meal every day

Drug-induced smell and/or taste disorders

Highly common
mechanisme rather diverse
  • cytotoxicity
  • neurotoxicity
  • taste aversion
  • effects on food reward
  • effect on saliva
  • bad taste

Effect of Dietary Antioxidants on Reactive Oxygen species (ROS)

Image

Vit C can increase the antioxidant levels but from the other antioxidants it is not known

Changes in ADME resulting from cachexia

  • Impaired gut wall function
  • Malabsorption
  • Reduced fat tissue and lean body mass
  • Hypoalbuminemia and increased concentration of alpha-1-acid glycoprotein
  • changed expression of metabolising enzymes and drug transporters
  • Impaired renal function

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