Interação fármaco-nutriente: uma revisão
Palabras clave:
interação alimento-droga, farmacologia clínica, absorção, alimentos, medicamentosResumen
A dieta influencia todos os estágios do ciclo da vida, fornecendo nutrientes necessários ao sustento do corpo humano. Alterações de ordem funcional e/ou estrutural, provocadas por doenças e infecções agudas ou crônicas, levam à utilização de medicamentos, cujo objetivo é restaurar a saúde. A via preferencial escolhida para a sua administração é a oral, entre outras razões, por sua comodidade e segurança. O fenômeno de interação fármaco-nutriente pode surgir antes ou durante a absorção gastrintestinal, durante a distribuição e armazenamento nos tecidos, no processo de biotransformação ou mesmo durante a excreção. Assim, é de importância fundamental conhecer os fármacos cuja velocidade de absorção e/ou quantidade absorvida podem ser afetadas na presença de alimentos, bem como aqueles que não são afetados. Por outro lado, muitos deles, incluindo antibióticos, antiácidos e laxativos podem causar má absorção de nutrientes. Portanto, o objetivo do presente artigo é apresentar uma revisão dos diversos aspectos envolvidos na interação fármaco-nutriente.
Citas
ANDERSON, K.E., CONNEY, A.H., KAPPAS, A. Nutrition and oxidative drug metabolism in man: relative influence of dietary lipids, carbohydrate, and protein. Clinical Pharmacology and Therapeutics, St. Louis MO, v.26, n.4, 493-501, 1979.
ANDERSON, K.E., CONNEY, A.H., KAPPAS, A. Nutritional influences on chemical biotransformations in humans. Nutrition Reviews, New York, v.40, n.6, p.161-171, 1982.
ANDERSON, K.E. Influences of diets and nutrition on clinical pharmacokinetics. Clinical Pharmacokinetics, Auckland, v.14, n.6, p.325-346, 1988.
BARREIRO, E.J., FRAGA, C.A.M. Química medicinal: as bases moleculares da ação dos fármacos. Porto Alegre : Artmed, 2001. 243p.
BASILE, A.C. Implicações clínicas das interferências alimento-medicamento-alimento na geriatria. Folha Médica, Rio de Janeiro, v.97, n.3, p.187-193, 1988.
BASILE, A.C. Fármaco e alimentos. In: SEIZI-OGA, I., AULUS, C.B. (Ed.). Medicamentos e suas interações. São Paulo : Atheneu, 1994. p.157-188.
CHEN, L.H., LIU, S., COOK NEWELL, M.E., BARNES, K. Survey of drug use by the elderly and possible impact of drugs on nutritional status. Drug-Nutrition. Interaction, New York, v.3, n.2, p.73-86, 1985.
CLARK, J.H., RUSSEL,G.J., FITZGERALD, J.F., NAGAMORI, K.E. Serum beta-carotene, retinol, and alpha-tocopherol levels during mineral oil therapy for constipation. American Journal of Diseases of Children, Chicago, v.141, n.11, p.1210-1212, 1987.
DUPUIS, L.L., KOREN, G., SILVERMAN, E.D., LAXER, R.M. Influence of food on the bioavailability of oral methotrexate in children. Journal of Rheumatology, Toronto, v.22, n.8, p.1570-1573, 1995.
DUVOISIN, R.C., SAGE, J. Parkinson’s Disease: a guide for patient and family. 4.ed. Philadelphia : Lippincott-Raven, 1996.
FLEISHER, D., CHENG, L., ZHOU, Y., PAO, L.H., KARIM, A. Drug, meal and formulation interaction influencing drug absorption after oral administration: clinical implication. Clinical Pharmacokinetics, Auckland, v.36, n.3, p.233-254, 1999.
FLODIM, N.W. Micronutrient supplements: toxicity and drug interactions. Progress in Food and Nutrition Science, Oxford, v.14, n.4, p.277-331, 1990.
GAI, M.N.H. Los alimentos como factor de modificación de la absorción de medicamentos: In: SIMPOSIO INTERNACIONAL DE BIODISPONIBILIDAD DE MEDICAMENTOS Y COLOQUIO SOBRE RELACIÓN UNIVERSIDAD E INDUSTRIA, 2., 1992, Santiago de Chile. Anais... Santiago de Chile : Universidad deChile, 1992. p.227-232.
GIL ESPARZA, A.M. Interacciones alimento-medicamento y autocuidado. Alimentaria, v.35, n.282, p.19-25, 1997.
GUYTON, A.C. Tratado de fisiologia médica. 8.ed. Rio de Janeiro : Guanabara Koogan, 1992. 862p.
HALSAS, M., HIETALA, J., VESKI, P., JURJENSON, H., MARVOLA, M. Morning versus evening dosing of ibuprofen using conventional and time-controlled release formulations. International Journal of Pharmaceutics, Amsterdam, v.189, n.2, p.179-185, 1999.
HAMAGUCHI, T., SHINKUMA, D., IRIE, T. Effect of a high-fat meal on the bioavailability of fenitoína in a commercial powder with a large particle size. International Journal of Clinical Pharmacology, Therapy, and Toxicology, Munchen, v.31, n.7, p.326-330, 1993.
HARRISON, L.I., RIEDEL, D.J., ARMSTRONG, K.E., GOLDLUST, M.B., EKHOLM, B.P. Effect of food on salsalate absorption. Therapeutic Drug Monitoring, New York, v.14, n.2, p.87-91, 1992.
HAYES, J.R., BORZELLECA, J.F. Nutrient interaction with drugs and other xenobiotics. Journal of the American Dietetic Association, Chicago, v.85, n.3, p.335-339, 1985.
HOYUMPA, A.M., SCHENKER, S. Major drug interactions: effect of liver disease, alcohol, and malnutrition. Annual Review of Medicine, Palo Alto, v.33, p.113-149, 1982.
INSOGNA, K.L., BORDLEY, D.R., CARO, J.E., LOCKWOOD, D.H. Osteomalacia and weakness from excessive antacid ingestion. JAMA, Chicago, v.244, n.22, p.2544-2546, 1980.
JOHNSON, B.F., O’GRADY, J., SABEY, G.A., BYE, C. Effect of a standard breakfast on digoxin absorption in normal subjects. Clinical Pharmacology and Therapeutics, St. Louis MO, v.23, n.3, p.315-319, 1978.
KEMPSTER, P.A., WAHLQVIST, M.L. Dietary factors in the management of parkinson’s disease. Nutrition Reviews, New York, v.52, n.2, p.51-58, 1994.
KIRK, J. Significant drug-nutrient interactions. American Family Physician, Kansas City MO, v.51, n.5, p.175-1182, 1995.
KRISHNASWAMY, K., USHASRI, V., NAIDU, A.N. The effect of malnutrition on the pharmacokinetics of phenylbutazone. Clinical Pharmacokinetics, Auckland, v.6, p.152-159, 1981.
LASSWELL, A.B., LORECK, E.S. Development of a program in accord with JCAHO standards for counseling on potential drug-food interactions. Journal of the American Dietetic Association, Chicago, v.92, n.9, p.1124-1125, 1992.
LAVELLE, J., FOLLANSBEE, S., TRAPNELL, C.B., BUHLES, W.C., GRIFFY, K.G., JUNG, D., DORR, A., CONNOR, J. Effect of food on the relative bioavailability of oral ganciclovir. Journal of Clinical Pharmacology, Hagerstown MD, v.36, n.3, p.238-241, 1996.
LIEDHOLM, H., WAHLIN-BOLL, E., MELANDER, A. Mechanisms and variations in the food effect on propranolol bioavailability. European Journal of Clinical Pharmacology, Berlin, v.38, n.5, p.469-475, 1990.
McCRAKEN, G.H., GINSBURG, C.M., CLAHSEN, J.C., THOMAS, M.L. Pharmacology evaluation of orally administered antibiotics in infants and children: effect of feeding on bioavailability. Pediatrics, Evanston IL, v.62, n.5, p.738-743, 1978.
MELANDER, A., DANIELSON, K., HANSON, A. Reduction of isoniazid bioavailability in normal men by concomitant intake of food. Acta Medica Scandinavica, Oslo, v.200, n.1/2, p.93-97, 1976. MELANDER, A., DANIELSON, K., HANSON, A., RUDELL, B., SCHERSTÉN, B., THULIN, T., WHALIN, E. Enhancement of hydralazine bioavailability by food. Clinical Pharmacology and Therapeutics, St. Louis MO, v.22, n.1, p.104-107, 1977.
MELANDER, A., LIEDHOLM, H., McLEAN, A. Concomitant food intake does enhance the bioavailability and effect of hydralazine. Clinical Pharmacology and Therapeutics, St. Louis MO, v.38, n.4, p.475-476, 1985.
MUNRO, H.N., SUTER, P.M., RUSSELL, R.M. Nutrition Requirements of the elderly. Annual Review of Nutrition, Palo Alto, v.7, p.23-49, 1987.
MURRAY, J.J., HEALY, M.D. Drug-mineral interaction: a new responsibility for the hospital dietitian. Journal of the American Dietetic Association, Chicago, v.91, n.1, p.66-73, 1991.
NEUVONEN, P.J., TURAKKA, H. Inhibitory effect of various iron salts on the absorption of tetracycline n man. European Journal of Clinical Pharmacology, Berlin, v.7, p.357-360, 1974.
NEUVONEN, P.J., KIVISTO, K.T., LEHTO, P. Interference of dairy products with the absorption of ciprofloxacin. Clinical Pharmacology and Therapeutics, St. Louis MO, v.50, n.5, p.498-502, 1991.
OHMAN, K.P., KAGEDAL, B., LARSSON, R., KARLBERG, B.E. Pharmacokinetics of captopril and its effects on blood pressure during acute and chronic administration and in relation to food intake. Journal of Cardiovascular Pharmacology, New York, v.7, p.20-24, 1985. Supplement 1.
OLIVEIRA, G.G. A Interação fármaco-nutriente sua importância na terapêutica. A Folha Médica, Rio de Janeiro, v.102, n.4, p.137-142, 1991.
PELLOCK, J.M., HOWELL, J., KENDING, E.L., BAKER, H. Pyridoxine deficiency in children treated with isoniazid. Chest, Park Ridge IL, v. 87, n.5, p.658-661, 1985.
QATO, M.K., MOHAMMED, F.A. Effect of food on the comparative bioavailability of two commercially available sustained-release tablet formulations containing nifedipine. STP Pharma Sciences, Paris, v.8, n.6, p.369-373, 1998.
RADULOVIC, L.L., CILLA, D.D., POSVAR, E.L., SEDMAN, A.J., WHITFIELD, L.R. Effect of food on the bioavailability of atorvastatin, an HMG-COA reductase inhibitor. Journal of Clinical Pharmacology, Hagerstown MD, v.35, n.10, p.990-994, 1995.
RANDINITIS, E.J., SEDMAN, A.J., WELLING, P.G., KINKEL, A.W. Effect of a high-fat meal on the bioavailability of a polymer-coated erytromycin particle tablet formulation. Journal of Clinical Pharmacology, Hagerstown MD, v.29, n.1, p.79-84, 1989.
REYNOLDS, J.E.F. Martindale: the extra pharmacopeia. 30.ed. London : Pharmaceutical Press, 1993. 2363p.
ROE, D.A. Drugs, diets and nutrition. American Pharmacy, Washington DC, v.18, n.10, p.62-64, 1978.
ROE, D.A. Nutrient and drug interactions. Nutrition Reviews, New York, v.42, n.4, p.141-154, 1984a.
ROE, D.A. Therapeutic significance of drug-nutrient interactions in the elderly. Pharmacological Reviews, Baltimore, v.36, n.2, p.109, 1984b.
ROE, D.A. Geriatric Nutrition. In: ROE, D.A. Therapeutic effects of drug-nutrient interactions in the elderly. Journal of the American Dietetic Association, Chicago, v.85, n.2, p.174-178, 181, 1985.
ROE, D.A. Drug and food interaction as they affect the nutrition of older individuals. Aging Clinical and Experimental Research, Milano, v.5, n.2, p.S51-S53, 1993. Supplement 1.
ROE, D.A. Medications and nutrition in the elderly. Primary Care, Philadelphia, v.21, n.1, p.135-147, 1994.
SATO, J., NAKATA, H., OWADA, E., KIKUTA, T., UMETSU, M., ITO, K. Influence of usual intake of dietary caffeine on single-dose kinetics of theophylline in healthy human subjects. European Journal of Clinical Pharmacology, Berlin, v.44, n.3, p.295-298, 1993.
SCHUMANN, K. Interaction between drug and vitamins at advanced. International Journal for Vitamin and Nutrition Research, Bern, v.69, n.3, p.173-178, 1999.
SELF, T.H., CHRISMAN, C.R., BACIEWICZ, A.M., BRONZE, M.S. Isoniazid drug and food interactions. American Journal of the Medical Sciences, Philadelphia, v.317, n.5, p.304-311, 1999.
SILVA, P. Farmacologia. 4.ed. Rio de Janeiro : Guanabara Koogan, 1994. 1450p.
SOUICH, P., CAILLÉ, G., PERREAULT, S. Influencia de los alimentos sobre la biodisponibilidad de los medicamentos. In: SIMPOSIO INTERNACIONAL DE BIODISPONIBILIDAD DE MEDICAMENTOS Y COLOQUIO SOBRE RELACIÓN UNIVERSIDAD E INDUSTRIA, 1., 1992, Santiago de Chile. Anais...Santiago de Chile : Universidad de Chile, 1992. p.53-69.
SWEET, R.A., BROWN, E.J., HEIMBERG, R.G. Monoamine oxidase inhibitor dietary restrictions: what are we asking patients to give up? Journal of Clinical Psychiatry, Memphis TN, v.56, n.5, p.196-210, 1995.
TERESI, M.E., MORGAN, D.E. Attitudes of healthcare professionals toward patient counseling on drug-nutrient interactions. Annals of Pharmacotherapy, Cincinnati, v.28, n.5, p.576-579, 1994.
THOMAS, J.A. Drug-nutrient interactions. Nutrition Reviews, New York, v.53, n.10, p.271-282, 1995.
TOOTHAKER, R.D., WELLING, P.G. The effect of food on drug bioavailability. Annual Review of Pharmacology and Toxicology, Palo Alto, v.20, p.173-199, 1980.
TROVATO, A., NUHLICEK, D.N., MIDTLING, J.E. Drug-nutrient interactions. American Family Physician, kansas City MO, v.44, n.5, p.1651-1658, 1991.
TRUSWELL, A.S. Nutrients in pharmacological doses, and adverse effects of foods in patients taking certain drugs. Journal of Science of Food and Agriculture, Sussex, v.26, n.7, p.1054-1074, 1975.
VARMA, R.J. Risk for drug-induced malnutrition is unchecked in elderly patients in nursing homes. Journal of the American Dietetic Association, Chicago, v.94, n.2, p.192-194, 1994.
WELLING, P.G. Influence of food and diet on gastrointestinal drug absorption: a review. Journal of Pharmacokinetics and Biopharmaceutics, New York, v.5, n.4, p.291-334, 1977.
WELLING, P.G. Bioavailability of erythromycin stearate: influence of food and fluid. Journal of Pharmaceutical Sciences, Washington DC, v.67, n.6, p.764-766, 1978.
WELLING, P.G., TSE, F.L.S. The influence of food on absorption of antimicrobial agents. Journal of Antimicrobial Chemotherapy, London, v.9, p.7-27, 1982.
WELLING, P.G. Interactions affecting drug absorption. Clinical Pharmacokinetics, Auckland, v.9, n.5, p.404-434, 1984.
WELLING, P.G. Effects of food on drug absorption. Pharmacology and Therapeutics, Oxford, v.43, n.3, p.425-441, 1989.
WESSEL, J.C., KOELEMAN, H.A., BONESCHANS, B., STEYN, H.S. Different types of breakfast and paracetamol absorption. International Journal of Clinical Pharmacology, Therapy, and Toxicology, Munchen, v.30, n.6, p.208-213, 1992.
WILLIAMS, L., DAVIS, J.A., LOWENTHAL, D.T. The influence of food on the absorption and metabolism of drugs. Clin. Nutr., v.77, n.4, p.815-829, 1993.
WIX, A.R., DOERING, P.L., HATTON, R.C. Drug-nutrition counseling programs in teaching hospitals. American Journal of Hospital Pharmacy, Washington DC, v.49, n.4, p.855-860, 1992.
YAMREUDEEWONG, W., HENANN, N.E., FAZIO, A., LOWER, D.L., CASSIDY, T. Drug-food interaction in clinical practice. Journal of Family Practice, East Norwalk CT, v.40, n.4, p.376-384, 1995.
ZENT, C., SMITH, P. Study of the effect of concomitant food on the bioavailability of rifampicin, isoniazid and pyrazinamide. Tubercle and Lung Disease, v.76, n.2, p.109-113, 1995.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2023 Mirian Ribeiro Leite MOURA, Felix Guillermo Reyes REYES
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
