Module 6 Reading Assignment - Medications and Special Diets

It is best to get all of your medications from the same pharmacy. True OR False

True

Those who consume a plant-based diet should make sure to consume adequate amounts of fortified foods to get enough: a. Folate b. Vitamin B12 c. Vitamin C d. Potassium

b. Vitamin B12

A patient has undergone bowel surgery and is NPO (nothing by mouth). Which modified diet would you expect to be ordered initially as a transition diet after intravenous feeding? a. Mechanical Soft b. Clear Liquid c. Blenderized liquid d. Fat Restricted

b. clear liquid

NPO refers to: a. Tube feeding b. Low fiber diet c. No food by mouth d. No dietary restrictions

c. No food by mouth

Medications that reduce stomach acidity, such as antacids, can impair the absorption of: a. Magnesium b. Vitamin C c. Folate d. Zinc

c. folate

High calorie, high protein diets

ndividuals with very high energy demand, malnutrition, or eating poorly, a high calorie high protein diet can help meet their bodies' demands. If tolerated, fat will often be increased in the diet when energy demand is high. Protein is increased often when individuals need excess kcalories as well as when they require extra healing

Drugs may alter food intake by:

* Altering the appetite * Interfering with taste or smell * Inducing nausea or vomiting * Interfering with oral function * Causing sores or inflammation in the mouth

Drugs and nutrients may interact and alter metabolism by:

- Acting as structural analogs (as do warfarin and vitamin K) - Using similar enzyme systems (phenobarbital includes liver enzymes that increase the metabolism of Folate, vitamin D, and vitamin K). - Competing for transport on plasma proteins (fatty acid and drugs may compete for the same sites on the plasma protein albumin.

Why are the nutrients present in plants not easily absorbed?

- This is because of phytates, oxalates, and fibrous compounds that attach themselves to nutrients in the plant, which may interfere with nutrient absorption once in the human body

Healthy Versus Unhealthy Plant-based Eating

- When it comes to health, what a person eats (includes) contributes to positive or negative health outcomes. - an individual may follow a vegan eating pattern but might include beer, french fries, potato chips, vegan cookies, vegan ice cream, vegan cakes, vegan donuts, etc. - ask your patient to explain what they eat in a day to understand whether it is healthy or not.

Diuretics

- are intended for people with edema to help get rid of excess water from the body - they also may cause a loss of electrolytes and other nutrients - Some diuretics can deplete calcium, potassium, magnesium, and thiamin - some diuretics cause the minerals to be retained

Drugs may alter nutrient absorption by

- changing the acidity of the digestive tract (antacids may interfere with iron and folate absorption) - damaging mucosal cells (cancer chemotherapy may damage mucosal cells) - binding to nutrients (bile acid binders bind to fat-soluble vitamins)

Those who consume a plant-based diet are more likely to have protein-energy malnutrition (PEM). True OR False

False

Food substances may alter drug excretion by:

Inducing the activities of liver enzymes that metabolize drugs, increasing drug excretion (components of charcoal-broiled meats increase the metabolism of warfarin, theophylline and acetaminophen).

Oxalates

Oxalates (in beets, nuts, chocolate, tea, wheat, bran) and phytates (the storage form of phosphorus found in plants' seeds and cell walls) can bind to medications.

Summary of Religious Influences on Diet

Refer to image attached

Match the religion with what is restricted in their diet. The task is to match the lettered items with the correct numbered items. Appearing below is a list of lettered items. Following that is a list of numbered items. Each numbered item is followed by a drop-down. Select the letter in the drop down that best matches the numbered item with the lettered alternatives. a. consuming meat and dairy together b. beef c. fish 1. Jewish 2. Hindu 3. 7th Day Adventist

a = Jewish b = Hindu c = 7th Day Adventist

Plant-based diets have been shown to decrease the risk of: (Select all that apply) [mark all correct answers] a. Cancer b. Heart disease c. Type 1 diabetes d. Cognitive decline e. Iron deficiency f. Obesity

a,b,d,f

Which of the following foods are associated with longevity? Select all that apply. [mark all correct answers] a. Beans b. Whole grains c. Dairy products d. Sweet potatoes e. Corn f. Citrus juices g. Leafy greens

a,b,d,g

Which of the following religions prohibit the consumption of pork? Check all that apply. [mark all correct answers] a. Jewish b. Muslim c. Mormon d. Roman Catholic e. Buddhist f. Seventh Day Adventist

a,b,e,f

Which of the following can be included on a clear liquid diet, often recommended before and after GI procedures and/or surgery? Check all that apply [mark all correct answers] a. Pulp-free fruit juices b. Clear meat broth c. Milkshakes d. Sugar-free coffee with non-dairy creamer e. Tea sweetened with sugar f. Plain hard candy g. Frozen juice bars h. Lowfat milk i. Flavored gelatin

a,b,e,g,i

Which of the following religions prohibits the consumption of coffee and tea? a. Mormon b. Jewish c. Buddhist d. Hindu

a. Mormon

Which nutrient may become deficient when a person is taking a diuretic? a. Potassium b. Iron c. Vitamin D d. Calcium

a. potassium

What is a primary difference between a clear liquid and a full liquid diet? a. A clear liquid diet only includes water and white tea, while full liquid diet includes all liquids b. A full liquid diet includes milk, while a clear liquid diet does not c. A clear liquid diet only includes liquids you can see through, while full liquid diets include all liquids d. A full liquid diet includes juices, while a clear liquid diet does not

b. A full liquid diet includes milk, while a clear liquid diet does not

Which nutrient's absorption is impaired by antacids? a. Vitamin D b. Iron c. Vitamin E d. Potassium

b. iron

Which food interacts with some types of blood pressure medication? a. chocolate b. milk c. gluten d. black licorice

d. black licorice

Which of the following has the most interactions with common medications? a. bananas b. soy milk c. starchy vegetables d. grapefruit juice

d. grapefruit juice

fat restricted diets

designed to decrease symptoms in people with absorption problems, pancreatitis, and cystic fibrosis, the fat restricted diet limits fat as low as 25 grams per day.

low residue diet

designed to decrease the load on the large intestine, low residue diets are low in fiber and other foods with a lot of residue left that is not digested and absorbed (such as milk products).

Changes in consistency or texture are usually done for chewing and swallowing problems. MECHANICAL SOFT:

ground consistency prescribed for chewing difficulties (usually dentition problems) or mouth pain.

Changes in consistency or texture are usually done for chewing and swallowing problems. DYSPHAGIA DIETS:

ground to pureed consistency of foods prescribed for individuals with swallowing problems.

Drugs may alter nutrient excretion by:

- Altering nutrient reabsorption in the kidneys (some diuretics increase excretion of sodium and potassium). - Causing diarrhea or vomiting (diarrhea and vomiting may cause electrolyte loss)

Nutritional considerations for plant-based diets include:

- An understanding of nutrient absorption. - Food sources of particular nutrients. - Food preparation.

Clear liquid

- Clear fluids and foods that are liquid at body temperature and have little to no undigested material (residue) left after digestion. - Foods allowed include: pulp free juices, carbonated beverages, gelatin, clear broths, popsicle, and fruit ice. This diet does not meet nutritional needs, only fluid and electrolytes. - diet is often used post-operatively and after long periods without food as the patient transitions into solid foods.

Plant-based Eating Patterns (listed from most liberal to most restrictive).

- Flexitarian: (A 'flexible vegetarian') consumes a semi-vegetarian diet. On occasion, the individual may include animal flesh (meat, poultry, fish), eggs, and/or dairy. - Pescatarian: follows a mostly plant-based diet but includes fish or shellfish (but no other animal flesh) and may or may not include eggs or dairy. - Lacto-ovo-vegetarian: follows a primarily plant-based diet but allows dairy and eggs as the only animal foods. - Lacto-vegetarian: follows a mostly plant-based diet but allows dairy as the only animal food. - Ovo-vegetarian: follows a primarily plant-based diet but allows eggs as the only animal food. - Vegan: follows an exclusively plant-based diet, does not consume any animal foods. That means no animal flesh (meat, poultry, fish), no eggs, no dairy, and nothing that is a derivative of any of these foods. For example, no gelatin (Jell-O or marshmallows) because gelatin comes from the bones of cows, pigs, or fish. No regular sugar because most table sugar is made using bone char (from the bone fragments of cattle) as a filtering agent. Also, for many vegans, honey is not included because it is made by bees with the belief that it is for bees and not humans.

Why would a person choose to eat a plant based diet?

- Geographic location - Religion - Philosophical beliefs - Sustainability - Health - Environmental Concerns - Animal Welfare

Food substances and drugs may interact and causes toxicity by:

- Increasing side effects of the drug (the caffeine in beverages can increase the adverse effects of stimulants). - Increasing drug action to excessive levels (grapefruit components inhibit the enzymes that degrade certain drugs, increasing drug concentration in the body).

Special Diet Orders are used before and after treatments and procedures to reduce the complications with treatment or tolerating the diet.

- NPO: nothing by mouth is often ordered both before and after procedures when an empty stomach is needed. NPO may also be ordered when bowel rest is needed, or the patient cannot tolerate oral nutrition. - Routine Progressive Diet: after an individual has been without oral nutrition, we must gradually introduce foods to make sure they tolerate it. The routine progressive diet starts after the NPO order has been lifted. It progresses from clear liquid to full liquid to soft, to the regular or modified diet.

Alternative feeding

- Routes are often required when an individual is not able to meet his/her nutritional needs with diet alone - Enteral nutrition delivers a nutritionally complete formula via a tube into the gastrointestinal tract (often referred to as tube feeding). - Parenteral nutrition delivers a nutritionally complete formula via a catheter directly into the circulatory system.

Foods and nutrients may alter drug absorption by:

- Stimulating the secretion of gastric acid (the antifungal agent ketocanazole is absorbed better with meals due to increased acid secretion). - Altering the rate of gastric emptying (intestinal absorption of drugs may be delayed when they are taken with food). - Binding to drugs (calcium binds to tetracycline, reducing the absorption of both substances). - Competing for absorption sites in the intestine (dietary amino acids interfere with levo dopa absorption).

Medications

- are necessary for the treatments of many diseases - All medicines have possible side effects, drug-drug interactions, and food-drug interactions - Patients at high risk include children, pregnant women, the elderly, and those who suffer from chronic disease or are on many medications - medications are prescribed by weight; therefore, an inaccurate weight may cause over or under-medicating.

full liquid diet

- includes all of the clear liquid foods plus milk, eggnog and cream soups. - still often used especially in the case of gastrointestinal disorders -Because liquid supplements are allowed, this diet can meet a person's nutritional needs -often ordered as part of the progressive diet as a person transitions to solid foods (but is becoming less common), or when foods cannot be chewed (facial fractures for example).

Interactions

- multiple medication use puts a person at risk for malnutrition - Medications can alter nutrient needs, and food components can alter the medication's effectiveness - Due to the number of medicines they typically take, the elderly are highly prone to nutrient-drug interactions. - Medications can reduce food intake by decreasing appetite, altering taste sensations and smells, and causing dry mouth, mouth sores, nausea, vomiting, dizziness, etc. - Nutrients and non-nutrients can significantly affect a medication's metabolism - Sometimes food or beverage can have properties that enhance the effect or increase the side effect - antacids can interfere with the absorption of nutrients such as iron, vitamin B12, Folate, and iron.

Antibiotics

- one of the most frequently prescribed short-term medications - Some vitamins and minerals may impair the absorption of antibiotics (such as calcium), so it is best not to take supplements or drink milk within two hours of taking the medication

What is a plant based diet?

- plant-based, describes many different eating patterns that predominantly contain whole plant foods as the primary energy source in the diet - This means that fresh fruits, vegetables, nuts, seeds, legumes (pulses, peas, and beans), and whole grains make up most of the diet - it consists of a variety and an abundance of whole plant foods that are most strongly associated with positive health outcomes and longevity - whole plant foods offer various nutrients, fiber, and phytochemicals that are unique to plants and are advantageous in the prevention, treatment, and potential reversal of diseases.

What distinguishes healthy plant-based eating patterns from unhealthy versions?

- the inclusion of a variety of whole plant foods in the diet and the minimization or exclusion of overly processed foods and sugary beverages - The word whole designates plant foods that are as close to how they exist in nature as possible - aim is to consume plant foods in their most natural form or prepared in a way to conserve their valuable nutrient, fiber, and phytochemical compounds. - focuses on consuming more fresh fruits, vegetables, whole grains, nuts, seeds, and legumes over and above everything else

Folate

- the nutrient that has the most interactions with medications and is quickly depleted by the body - Other ingredients found in medications can be undesirable, such as sugar, sorbitol, lactose, sodium, and caffeine, and can negatively affect those with diabetes, allergies, etc.

soft bland diet

- the soft diet is gastrointestinally soft and is different than the mechanical soft ordered for chewing problems - soft diet includes regular consistency foods, but limits spices, fiber/residue, and caffeine -This diet is not always necessary in the diet progression and is often not used.

sodium restricted diets

designed to prevent or correct fluid imbalances in disorders such as high blood pressure, kidney failure, and congestive heatr failure, sodium is normally restricted to 2,000 - 3,000 mg per day. However, stricter 1,000 mg per day sodium restrictions are sometimes warranted.