Drug Category and Name |
Nutritional Implications |
Labs to Monitor |
Diuretics |
|
|
Chlorothiazide (potassium-depleting) |
- urinary loss of Na, K, Cl, Mg, P, Zn, riboflavin (B2), bicarb
|
- monitor fluid and electrolyte status
|
| Furosemide (potassium-depleting) |
- urinary loss of Na, Cl, Mg and Ca
|
- monitor fluid and electrolyte status
|
| Spironolactone (potassium-sparing) |
- urinary loss of Na, Cl, Mg and Ca
- chronic therapy may cause renal calculi and osteopenia
|
- monitor fluid and electrolyte status
|
Corticosteroids |
|
|
| Dexamethasone
Prednisone or Prednisolone |
- may cause hyperglycemia
- urinary loss of K, Ca, Zn, vitamin C
- caution with K-depleting meds
- decreased absorption of Ca and P may lead to alterations of bone mineralization
- may inhibit growth
- may lead to altered protein metabolism
- may cause GI ulceration and/or hemorrhage
|
- monitor growth and bone mineral status with chronic use
- monitor blood pressure
|
Cardiorespiratory |
|
|
| Albuterol |
- appetite and activity changes
|
- monitor dietary intake and growth
|
| Theophylline |
- may cause GI irritation, feeding intolerance, anorexia
- avoid extremes of dietary protein or carbohydrate intakes
|
|
| Digoxin |
- may cause feeding intolerance
- avoid excessive calcium and vitamin D supplementation
|
- monitor dietary intake from foods and supplements
|
| Caffeine |
- insomnia, increased heart rate, irritability
- GI distress
|
- monitor dietary intake and growth
|
Neurological |
|
|
| Phenobarbitol |
- may increase turnover of vitamins D, K and folate
- may cause decreased bone density and osteomalacia
|
- monitor vitamins D, K and folate status
- monitor bone density
|
| Other anticonvulsants such as phenytoin sodium and valproic acid |
- affect metabolism of vitamins D, K, B6, B12, folate and calcium
|
- monitor dietary adequacy of vitamins D, K, B6, B12, folate and calcium
|
Antibiotics |
|
|
| Vancomycin HCl,
Gentamicin (Garamycin), Ciprofloxacin (Cipro),
Doxycycline, Erythromycin |
- may cause nausea, diarrhea
- long-term use may alter GI flora and nutrient availability--especially vitamin K
|
- monitor dietary intake and growth
- long-term use, monitor vitamin K status
|
