Nutrition and Oral Medicine (Nutrition and Health)

Chapter 6 / Medications, Nutrition, Diet, and Oral Health 101Table 5Drugs Associated With Esophageal DamageAcid-containing productsAntiarrhythmicsAspirinBisphosphonatesIron-containing productsMethylxanthinesNonsteroidal anti-inflammatory drugsPotassium chlorideVitamin C (ascorbic acid) productsAdapted from ref. 45, 47, and 48.Clindamycin (Cleocin)Doxycycline (Vibramycin)Erythromycin (Ery-tabs, E-mycin)Minocycline (Minocin)Pentamidine (NebuPent)Tetracycline (Sumycin)Quinidine (Quinaglute, Cardioquin)Bayer Aspirin, othersAlendronate (Fosamax)Tiludronate (Skelid)FeoSol, Feratab, Slow FE, Fer-Iron, othersTheophylline (Theo-Dur, Unidur, Slo-Bid)Ibuprofen (Advil, Motrin)Indomethacin (Indocin)Ketoprofen (Orudis)Naproxen (Aleve, Naprosyn)K-Dur, K-Tabs, Klor-Con, Micro-K, Slow-K, othersto exist between oral hygiene and the degree of gingival enlargement. In rare cases, theextent of the gingival hyperplasia is such that it impedes the patient’s ability to eat, andexcess tissue must be surgically removed.7. CONCLUSIONThe interactions between drugs and nutrition are becoming more important given theaging of the population and the increased usage of multiple medications on a chronicbasis. Unwanted outcomes include reduction in the intended response to a therapeuticdrug because of diet-induced changes in drug bioavailability or metabolism, druginducednutritional deficiencies, and drug–food/drug–nutrient incompatibility reactions(50). Risk of drug–nutrient interactions and their outcomes depends on the patient’s age,physiologic status including renal and hepatic function, number of drugs being taken,and the diet. Predictions of the risk of drug and nutrient interaction may be possible ifthe characteristics of prescribed drugs and diet are known. Diagnosis of a clinical problemas an adverse drug–nutrient interaction depends on recognizing that the problemappeared after the drug has been prescribed and/or a change in diet has occurred. Laboratorytests may be useful in clarifying the diagnosis, especially with drug-inducedvitamin deficiencies. Avoidance of drug–nutrient interactions depends on knowledge ofthe risk as well as avoidance of drug–nutrient or drug–food intake that imposes a highrisksituation (50). Careful monitoring of the oral cavity for signs of drug–nutrientvitamin deficiencies (such as atrophic glossitis) can allow intervention before a patient’s