Nutrition Interventions for Children with Special Health Care Needs

Chapter 5
Section 2 - Problem-Based Nutrition Interventions
Medication-Nutrient Interactions
Starla Blank, RPh, PharmD and Eileen Harper, Med, RD, CD
Updated by Lori Brizee, MS, RD, CSP, LD
Medications and nutrients are known to interact, sometimes with detrimental effects.
Medications can affect nutritional status in the following ways:
• altering the absorption, metabolism, and/or excretion of specific nutrients
• causing gastrointestinal disturbances and/or anorexia, thereby decreasing overall
nutrient intake
• increasing appetite which can result in obesity
• interacting with nutrients prior to ingestion (e.g. when mixed with food or formula
before administering)
Additionally, specific foods and nutrients are known to interfere with the action of
certain medications by altering the absorption or metabolism of the medication.
Children with special health care needs are at risk for medication-nutrient
interactions, especially when medications are used long-term, multiple medications
are prescribed, and nutrient intake is marginal (1). Other issues to consider include
interactions between medications and vitamin and mineral supplements and the
timing of medication administration related to meals and snacks. This section
discusses ten types of medications that have documented effects on nutrients and
are commonly used in the treatment of children with special health care needs (2).
Anticonvulsants
Children with neurologic impairments often have secondary seizure disorders that
are treated with anticonvulsant medications. Long-term use of anticonvulsant
medications places a child at risk for deficiencies of vitamin D, folic acid, and possibly
other vitamins, including vitamins B6 and B12 (3,4). Routine assessment for vitamin
deficiencies is an important component of comprehensive health care for these
patients. Some anticonvulsants can cause side effects such as nausea, vomiting,
diarrhea, and lethargy (3). Other side effects include weight loss or gain (5).
Nutrition Interventions for Children With Special Health Care Needs 59