Nutrition Interventions for Children with Special Health Care Needs

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Chapter 5 - Medication-Nutrient Interactions Corticosteroids Glucocorticoids are used as replacement therapy in adrenal cortical deficiency states and for anti-inflammatory and immunosuppressive effects in the treatment of many disorders, including asthma. Side effects of glucocorticoids include decreased bone mineral density, and decreased absorption of calcium and phosphorus; poor linear growth; increased appetite often leading to excessive weight gain; sodium and water retention occasionally leading to hypertension; muscle catabolism; increased glucose leading to insulin resistance; and increased lipolysis (16,17). Inhaled corticosteroids are now more commonly used than systemic corticosteroids. Their side effects are minimal compared to oral corticosteroids, but they can have similar effects when used long term. Antidepressants Tricyclic antidepressants (TCAs) are used to treat mental depression, as an aid in the temporary treatment of nocturnal enuresis in children over the age of six years, and as a treatment for ADHD for some young adults and children over six years of age. Although the exact mechanism of action in the treatment of depression is unclear, TCAs have been thought to increase the synaptic concentration of norepinephrine and/or serotonin in the central nervous system. Nutrition-related side effects of TCAs can include an increased appetite and weight gain, dry mouth, nausea and vomiting, constipation, and diarrhea. The relatively new antidepressant medications, selective serotonin reuptake inhibitors (SSRIs) may cause dry mouth and GI disturbances such as nausea and vomiting, dyspepsia, diarrhea or constipation (18,19). Antibiotics Antibiotics are used to treat infections. They are sometimes used long-term on a prophylactic basis. Side effects that may interfere with an adequate nutrient intake include mouth and tongue sores, diarrhea, nausea, and vomiting (1). With long-term use, gut flora can be altered, decreasing vitamin K production (20). Monitoring of nutritional effects is indicated. Anti-Inflammatory Medications Anti-inflammatory medications (e.g. sulfasalazine for ulcerative colitis and Crohn’s disease) can cause nutrition-related side effects including anorexia, nausea, vomiting, taste changes, diarrhea, gastric distress, and abdominal discomfort (20). 62 Nutrition Interventions for Children With Special Health Care Needs
Section 2 - Problem-Based Nutrition Interventions Anti-Gastroesophageal Reflux Disease Medications These medications are used to treat heartburn due to gastroesophageal reflux disease (GERD) by increasing GI motility. This acceleration of gastric emptying could affect the rate of absorption of other medications (21). A wide range of nutritional side effects may also occur, including constipation, diarrhea, nausea, vomiting, and abdominal pain and discomfort. Antispasmodics Antispasmodic medications are prescribed for bladder instability, e.g., with myelomeningocele. Some of the nutrition-related adverse effects include nausea, dry mouth, constipation, abdominal pain, anorexia, dysgeusia, and difficulty with swallowing (22). The remainder of this chapter presents guidelines for nutrition assessment, intervention, and evaluation/outcome for nutrition assessment, intervention, and evaluation/outcome for specific medication-nutrient interactions. Nutrition Interventions for Children With Special Health Care Needs 63
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Nutrition Interventions for Childre
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Kay Kopp, OTR/L Occupational Therap
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Appendices Appendix A Sample Screen
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ii Nutrition Interventions for Chil
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Population “Children with special
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vi Nutrition Interventions for Chil
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Chapter 1 - Nutrition Screening and
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Chapter 9 - Behavior Issues Related
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Chapter 10 - Enteral Feeding Other
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Refere
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Chapter 11 - Community Monitoring o
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Chapter 12 - Accommodating Special
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Chapter 13 - Nutrition Intervention
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Chapter 22 - Ketogenic Diet for Sei
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Appendix A Please list any other nu
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Appendix A Baby formula What kind o
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Appendix B Manufacturer Description
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Appendix C 282 Nutrition Interventi
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Appendix D 284 Nutrition Interventi
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Appendix E 292 Nutrition Interventi
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Appendix E Table 3: Parent-Specific
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Appendix F Percentiles of Upper Arm
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Appendix F 302 Nutrition Interventi
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Appendix G 304 Nutrition Interventi
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Appendix H 312 Nutrition Interventi
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Appendix I 320 Nutrition Interventi
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Appendix J 328 Nutrition Interventi
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Appendix K 336 Nutrition Interventi
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Appendix K 338 Nutrition Interventi
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Appendix L 340 Nutrition Interventi
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Appendix M 342 Nutrition Interventi
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Appendix M 344 Nutrition Interventi
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Appendix N Gastrostomy Tube Feeding
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Appendix N activities. When feeding
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Appendix N Feeding Sets/Extensions
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Appendix N Fluid and Electrolytes W
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Appendix N osmolality of full-stren
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Appendix N Modular Products Modular
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Appendix N his family, and the home
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Appendix N • The feeding tube may
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Appendix N equipment. The Special S
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Appendix N Table N-2: Common Compli
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Appendix N Complication Possible Ca
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Appendix N 368 Nutrition Interventi
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Appendix O Some conditions increase
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Appendix O Table O-3: Recommended P
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Appendix O 374 Nutrition Interventi
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Appendix P Diet Prescription for Me
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Appendix Q Goals Considerations for
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Appendix R Condition Description Nu
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Appendix R Condition Description Nu
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Appendix R References 1. Ekvall SW
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Appendix S Table S-1: Infant Formul
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Appendix S Comments Osmolality (mOs
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Appendix S Table S-2: Pediatric For
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Appendix S Table S-3: Modular Produ
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Appendix S Comments Energy (kcal) P
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Appendix S Contact Information Abbo
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Appendix T Powdered Formulas Accura
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Appendix T Table T-1: Liquid Concen
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Appendix T 402 Nutrition Interventi
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Appendix U Nutrition Strategies for
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Appendix U ADA Pocket Guide to Nutr
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Glossary Autism Spectrum Disorders
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Glossary Early intervention service
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Glossary Length (recumbent length)
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Glossary Stadiometer moveable headb
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Index specialist 98 target 108 Bink
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Index elemental formula 348 elimina
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Index I ICF. See International Clas
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Index risk indicators 4 screening 1
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Index suppositories 72, 77 Surmonti
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