Drug-Food Interactions Quiz
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Questions and Answers

What is a potential consequence of taking an MAOI with tyramine-rich foods?

  • Increased metabolism of catecholamines
  • Hypertensive crisis (correct)
  • Inhibition of tyramine release
  • Decreased absorption of nutrients

How does calcium in milk interact with certain antibiotics?

  • Enhances the effectiveness of the antibiotics
  • Increases their side effects
  • Neutralizes the antibiotics
  • Decreases the absorption of the antibiotics (correct)

What effect does excessive vitamin K intake have when taking warfarin?

  • Increases warfarin effect
  • Causes vitamin D deficiency
  • Decreases warfarin effect (correct)
  • No interaction is observed

What is the effect of grapefruit juice on certain medications?

<p>Inhibits CYP3A4 enzyme activity (D)</p> Signup and view all the answers

What impact do high fiber foods have on drugs like atorvastatin?

<p>Decrease GI absorption of the drug (A)</p> Signup and view all the answers

How does folic acid interact with antiepileptic drugs?

<p>Inhibits folate absorption (A)</p> Signup and view all the answers

What substance can lead to depletion of folic acid when taken with antibiotics?

<p>Cholesterol (D)</p> Signup and view all the answers

What is the result of antacids interacting with folic acid?

<p>Decreases folate absorption (C)</p> Signup and view all the answers

What effect does ascorbic acid have when combined with aspirin?

<p>Decreases mucosal damage (A)</p> Signup and view all the answers

Which drug interaction leads to vitamin B6 deficiency?

<p>Isoniazid (B)</p> Signup and view all the answers

What happens to vitamin D levels when using a CYP450 inducer like phenytoin?

<p>Decreases blood levels of vitamin D (A)</p> Signup and view all the answers

Which of the following drugs can interfere with the absorption of calcium?

<p>Orlistat (C)</p> Signup and view all the answers

What is a consequence of taking NSAIDs chronically in relation to iron?

<p>Enhanced iron deficiency and anemia (C)</p> Signup and view all the answers

What can cause hypokalemia in patients?

<p>Colchicine (A)</p> Signup and view all the answers

Which combination of substances binds iron and affects its absorption?

<p>Polyphenols and tannins (D)</p> Signup and view all the answers

Which antibiotic can decrease the bioavailability of zinc?

<p>Ciprofloxacin (A)</p> Signup and view all the answers

Flashcards

Ascorbic acid and aspirin interaction

Ascorbic acid (vitamin C) can reduce mucosal damage and gastric acidity caused by aspirin-generated free radicals.

Ascorbic acid and oral contraceptives

Ascorbic acid can increase serum estrogen levels, potentially leading to adverse reactions in women taking oral contraceptives.

Vitamin B complex and drug interactions

Certain medications can affect the absorption and blood levels of vitamin B complex, leading to deficiencies.

Vitamin D and CYP450 inducers

CYP450 inducers can increase vitamin D metabolism, leading to lower blood levels and potential deficiency.

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Vitamin D and absorption interference

Drugs interfering with absorption can cause vitamin D deficiency.

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Vitamin K and warfarin interaction

Vitamin K excess can reduce the effectiveness of warfarin, increasing the risk of thrombosis.

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Calcium and drug interactions

Certain drugs can interfere with calcium absorption, leading to potential deficiency.

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Iron and chelating agents

Iron absorption can be reduced by chelating agents, which bind to iron and make it less available for absorption.

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MAOI-Tyramine Interaction

MAOIs inhibit the breakdown of tyramine in the body, leading to a build-up of tyramine in the blood. Tyramine indirectly stimulates the release of catecholamines, like adrenaline, causing a surge in blood pressure.

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Milk and Dairy Products - Antibiotic Interaction

Calcium in milk or dairy products can bind to certain antibiotics, such as tetracycline and ciprofloxacin, forming a complex that reduces the antibiotic's absorption and effectiveness.

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Warfarin - Vitamin K Interaction

Excessive intake of vitamin K-rich foods can decrease the effectiveness of warfarin, a blood thinner, increasing the risk of blood clots.

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Grapefruit Juice - Drug Interaction

Grapefruit juice can inhibit the enzyme CYP3A4 in the intestines and liver, leading to increased blood levels of certain drugs, potentially enhancing both their beneficial and adverse effects.

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Fiber - Drug Interaction

Fiber can interfere with the absorption of some drugs in the gastrointestinal tract, potentially reducing their effectiveness.

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Caffeine - Drug Interaction

Caffeine can be affected by drugs like cimetidine and ciprofloxacin, resulting in slower caffeine breakdown, leading to elevated blood levels and potentially enhanced CNS and cardiovascular effects.

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B-Carotene - Drug Interaction

Drugs like antibiotics, laxatives, and cholesterol-lowering medications can interfere with the absorption of fat-soluble vitamins, including vitamin A, D, E, and K.

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Folic Acid - Antiepileptic Drug Interaction

Antiepileptic drugs like phenytoin can interfere with folate absorption and increase its breakdown, reducing folate levels in the body.

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Study Notes

Drug-Food Interactions

  • MAOI + tyramine in food: Increases blood tyramine levels, leading to uncontrolled catecholamine release. This can cause a hypertensive crisis with symptoms including hypertension, headache, tachycardia, arrhythmia, and stroke.

  • Milk and dairy products + tetracycline/ciprofloxacin: Forms a chelate, reducing antibiotic absorption and effectiveness.

  • Warfarin + vitamin K-rich foods: Excessive vitamin K intake reduces warfarin's anticoagulant effect, increasing the risk of thrombosis. Examples of high vitamin K foods are foods like bran, liver, spinach, broccoli, cabbage, and lettuce.

  • Grapefruit juice + drugs: Grapefruit juice inhibits CYP3A4 in the small intestine and liver, reducing drug metabolism. This leads to higher blood levels of the drug, increasing its effects and potential side effects.

  • Drugs + fiber: Fiber reduces the absorption of certain drugs, decreasing their serum levels and effectiveness.

  • Drugs + caffeine: Some drugs slow the metabolism of caffeine, leading to higher blood levels and potentially excessive nervous system (CNS) or cardiovascular effects.

Drug-Vitamin Interactions

  • B-carotene + drugs: Certain drugs (antibiotics, laxatives, cholesterol-lowering drugs) interfere with the absorption of fat-soluble vitamins including B-carotene and ADEK. This reduces absorption and blood levels.

  • Folic acid + antiepileptic drugs: Antiepileptic drugs (e.g., phenytoin) inhibit folate absorption and can also induce CYP450 enzymes. Antacids also interfere with folate absorption.

  • Ascorbic acid + aspirin: Aspirin can increase the damage to the gastrointestinal tract. Ascorbic acid can affect estrogen levels in oral contraceptives which can cause adverse reactions.

  • Vitamins + oral contraceptives/isoniazid/cyclosporine: These drugs can reduce absorption and blood levels of some vitamins, leading to deficiencies (e.g. vitamin B6 deficiency). This can lead to anemia and peripheral neuropathy.

Drug-Mineral Interactions

  • Calcium + drugs: Drugs like aluminum- or magnesium-containing antacids, cholestyramine, tetracyclines, quinolones, and corticosteroids, reduce calcium absorption. Phenytoin or Phenobarbital also decrease calcium absorption.

  • Iron + drugs: Chelating agents (e.g., clofibrate, deferoxamine, dimercaprol, EDTA), and quinolones reduce iron absorption. Aspirin or NSAIDs (non-steroidal anti-inflammatory drugs) can increase the risk of gastrointestinal bleeding and iron deficiency anemia. Iron (non-heme) binds to polyphenols and tannins in coffee, black tea leading to poor absorption of iron. This is important for infants children, pregnant, and lactating women.

  • Potassium + drugs: Some drugs (e.g., amphotericin B, colchicine, corticosteroids, laxatives, ACE inhibitors, losartan, spironolactone, cyclosporine) can either decrease or increase potassium levels (hyper/hypokalemia), potentially leading to cardiotoxicity.

  • Zinc + drugs: Drugs like ciprofloxacin and tetracyclines can reduce the absorption and bioavailability of zinc.

Vitamin B, K, and D Interactions

  • Vitamins + CYP450 inducers: CYP450 inducers (e.g., phenytoin, phenobarbital) affect the metabolism of vitamins D and K, leading to reduced blood levels and deficiency symptoms.

  • Drugs interfering with vitamin absorption: Drugs can interfere with absorption of vitamins, e.g. cholestyramine, neomycin, orlistat (decrease Vitamin D) and cholestyramine and mineral oil (decrease vitamin K).

  • Drugs enhancing bone mineralization: These drugs enhance effects of certain nutrients for bone mineralization (e.g. biphosphonate, estrogen/progestrin) potentially causing synergistic interactions.

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Description

Test your knowledge on drug-food interactions and their effects on medication absorption and metabolism. This quiz covers important combinations like MAOIs with tyramine, warfarin with vitamin K, and the impact of grapefruit juice on drug effectiveness. Gain a deeper understanding of how dietary choices can influence pharmacology.

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