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Nutrition Interventions for Children with Special Health Care Needs

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Chapter 5 - Medication-Nutrient Interactions<br />

Assessment Intervention Evaluation/Outcome<br />

ANTIDEPRESSANTS Examples: Tricyclic antidepressants (TCAs) - amitriptyline (Elavil); amoxapine (Asendin); clomipramine (Anafranil); desipramine<br />

(Norpramin); imipramine (Tofranil); nortriptyline (Aventyl, Pamelor); protriptyline (Vivactil); trimipramine (Surmontil);<br />

Decreased GI distress.<br />

Selective Serotonin Reuptake Inhibitors (SSRIs) -fluoxetine (Prozac); sertraline (Zoloft)<br />

Assess if patient on tricyclic<br />

Monitor <strong>for</strong> dry mouth, taste changes, GI distress<br />

antidepressants (TCAs) or selective<br />

serotonin receptor inhibitors (SSRIs) Take in morning <strong>with</strong>out regard to meals<br />

Appropriate rate of growth and<br />

weight gain<br />

Decreased GI distress<br />

Monitor weight<br />

Assess if problem <strong>with</strong> gastric irritation Take medication <strong>with</strong> or immediately after food to lessen irritation (<strong>for</strong><br />

TCAs)<br />

Adequate riboflavin intake<br />

Requirements <strong>for</strong> riboflavin may be increased/may interfere <strong>with</strong><br />

the biochemical assessment of riboflavin’s effect or induce riboflavin<br />

depletion.<br />

Assess if patient on amitriptyline or<br />

imipramine<br />

Serum albumin is <strong>with</strong>in<br />

normal limits<br />

ANTI-ANXIETY Examples: diazepam (Valium)<br />

Monitor <strong>for</strong> dry mouth, nausea,<br />

Increase free water as needed<br />

constipation, hypoalbuminemia (<strong>with</strong><br />

usage over 4 weeks)<br />

Check serum albumin every 6 months<br />

66 <strong>Nutrition</strong> <strong>Interventions</strong> <strong>for</strong> <strong>Children</strong> With <strong>Special</strong> <strong>Health</strong> <strong>Care</strong> <strong>Needs</strong><br />

Problems <strong>with</strong> dry mouth,<br />

constipation are minimized<br />

Ensure protein needs are met; modify protein intake as needed<br />

ANTIBIOTICS Examples: cefazolin (Ancef, Kefzol); cefotaxime (Cla<strong>for</strong>an); cefotetan (Cefotan); ceftizoxime (Cefizox); ceftriaxone (Rocephin);<br />

penicillin; vancomycin<br />

Rate of growth and weight<br />

gain is appropriate<br />

Assess <strong>for</strong> anorexia or GI distress Anorexia – Suggest small, frequent meals<br />

GI distress - If appropriate, suggest medication be taken <strong>with</strong> meals<br />

GI distress is minimized<br />

Decreased GI distress<br />

ANTI-INFLAMMATORY Examples: sulfasalazine (Asulfidine)<br />

Assess <strong>for</strong> GI distress<br />

Take <strong>with</strong> water after meals or <strong>with</strong> food<br />

Sufficient urine output<br />

Ensure output of 1500 cc/day<br />

Assess fluid intake<br />

Prevent folate deficiency<br />

Folate supplement (1 mg/day) recommended<br />

Assess folate intake<br />

Take folate separately from medication

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