Determine People who are at risk from drug-nutrient interactions?

People who are at risk from drug-nutrient interactions are the:

1. Persons who have a poor diet or in other words have a poor nutritional status. Existing malnutrition places patients at greater risk. Protein alteration, particularly low albumin level, as you may recall studying earlier, can effect drug disposition,

2. Persons who have serious health problems. Patients with active neoplastic diseases (cancer) or active acquired immunodeficiency syndrome (AIDS) with significant anorexia and muscle wasting are at special risk.

3. Body composition: This is an important consideration in determining drug response. In obese or older patients, for instance, the proportion of adipose tissue to lean body mass is decreased. Accumulation of a drug and its metabolite in adipose tissue is greater, and may result in prolonged clearance and increased toxicity.

4. Foetus, growing children, pregnant women: These individuals are at high risk for drug nutrient interaction. The physiological changes that occur with age, such as a decrease in lean body mass and body water, fall in plasma protein concentration, and a general decline in renal and liver Function, mean that the risk of adverse drug reactions is much higher. Elderly people are also more likely to be given the types of drugs with powerful effects and which are most likely to have an impact on nutrition e.g., cytotoxic drugs, anti-Parkinson's drugs and antidiabetic drugs. Diminished salivation may make it more difficult to swallow tablets and oesophageal motility disorders may lead to bulky drugs sticking in the oesophageal mucosa. Other problems such as failing memory, poor hearing and vision, and difficulty with opening containers may mean that drug regimens are not followed correctly, particularly if they are complex. Many of these factors are likely to coexist in elderly people.