Skip to main content

The Impact of Protein-Calorie Malnutrition on Drugs

  • Chapter
Handbook of Drug-Nutrient Interactions

Part of the book series: Nutrition and Health ((NH))

  • 751 Accesses

Abstract

Nutritional factors may influence the absorption, metabolism, distribution, and clear­ance of medications. This chapter focuses on malnutrition and its impact on the safe and effective management of medications. The scope of this chapter does not extend to a consideration of the effects of particular drugs on nutritional status.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Torun B, Chew F. Protein-energy malnutrition. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease ( 9th ed. ). Lipppincott Williams and Wilkins, Philadelphia, PA, 1999, pp. 963–988.

    Google Scholar 

  2. Victora CG, Kirkwood BR, Ashworth A, et al. Potential interventions for the prevention of childhood pneumonia in developing countries: improving nutrition. Am J Clin Nutr 1999; 70: 309–320.

    CAS  Google Scholar 

  3. Detsky AS, McLaughlin JR, Baker JP. What is subjective global assessment of nutritional status? J Parent Ent Nutr 1987; 11: 8–13.

    Article  CAS  Google Scholar 

  4. Covinsky KE, Martin GE, Beyth RJ, Justice AC, Sehgal AR, Landefeld CS. The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients. J Am Geriatr Soc 1999; 47: 532–538.

    CAS  Google Scholar 

  5. Abidoye RO, Soroh KW. A study on the effects of urbanization on the nutritional status of primary school children in Lagos, Nigeria. Nutr and Health 1999; 13: 141–151.

    Article  Google Scholar 

  6. Sullivan DH, Walls RC. Protein energy undernutrition and the risk of mortality within six years of hospital discharge. Am Coll Nutr 1998; 17: 571–578.

    Article  CAS  Google Scholar 

  7. Sullivan D, Sun S, Walls, RC. Protein-energy undernutrition among elderly hospitalized patients: a prospective study. JAMA 1999; 281: 2013–2019.

    Article  CAS  Google Scholar 

  8. Pekcan G, Karagaoglu N. State of nutrition in Turkey. Nutrition and Health 2000; 14: 41–52.

    Article  CAS  Google Scholar 

  9. Abidoye RO, Sikabofori. A study of prevalence of protein energy malnutrition among 1–5 years in rural Benue State, Nigeria. Nutr and Health 2000; 13: 235–247.

    CAS  Google Scholar 

  10. Anonymous. Severe malnutrition among young children—Georgia, January 1997–June 1999. JAMA 2001; 285: 2573–2574.

    Article  Google Scholar 

  11. Liu T, Howard RM, Mancini AJ, et al. Kwashiorkor in the United states: Fad diets, perceived and true milk allergy, and nutritional ignorance. Arch Dermatol 2001; 137: 630–636.

    CAS  Google Scholar 

  12. Motil KJ. Sensitive measures of nutritional status in children in hospital and in the field. Int J Cancer 1987; 11: 2–9.

    Google Scholar 

  13. Reilly JJ, Weir J, McColl JH, Gibson BES. Prevalence of protein-energy malnutrition at diagnosis in children with acute lymphoblastic leukemia. J Ped Gastroenterol Nutr 1999; 29: 194–197.

    Article  CAS  Google Scholar 

  14. Lares-Asseff I, Flores-Perez J, Juarez-Olguin H, Ramirez-Lacayo M, Laredo-Abdala A, CarbajalRodriguez L. The influence of nutritional status on the pharmacokinetics of ASA and its metabolites in children with autoimmune diseases. Am J Clin Nutr 1999; 69: 318–324.

    CAS  Google Scholar 

  15. Nord M, Kabbani N, Tiehen L, Andrews M, Bickel S, Carlson S. Household food insecurity in the US, 2000. USDA Food Assistance Nutrition Research Report No. 21, 2002.

    Google Scholar 

  16. Kessler L, Daley H, Malenga G, Graham S. The impact of the human immunodeficiency virus type 1 on the management of severe malnutrition in Malawi. Ann Tropical Paediatrics 2000; 20: 50–56.

    Article  CAS  Google Scholar 

  17. Studley HO. Percentage of weight loss: A basic indicator of surgical risk in patients with chronic peptic ulcer. JAMA 1936; 106: 458–459.

    Article  Google Scholar 

  18. Cannon PR. Protein deficiency and infection. Ann Surg 1944; 120: 514–525.

    CAS  Google Scholar 

  19. Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri S. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the national VA surgical risk study. Arch Surg 1999; 134: 36–42.

    Article  CAS  Google Scholar 

  20. Rady MY, Ryan T, Starr NJ. Clinical characteristics of preoperative hypoalbuminemia predict outcome of cardiovascular surgery. J Parent Ent Nutr 1997; 21 (2): 81–90.

    Article  CAS  Google Scholar 

  21. Hoffer JT. Metabolic consequences of starvation. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition In Health and Disease ( 9th ed. ). Lipppincott Williams and Wilkins, Philadelphia, PA, 1999, pp. 645–666.

    Google Scholar 

  22. Basu TK. Interaction of drugs and nutrition. J Hum Nutr 1977; 31: 449–458.

    CAS  Google Scholar 

  23. Walter-Sack I, Klotz U. Influence of diet and nutritional status on drug metabolism. Clin Pharmacokinet 1996; 31: 47–64.

    Article  CAS  Google Scholar 

  24. Mehta S, Nain CK, Sharma B, Mathur VS. Drug metabolism in malnourished children. Nutrition in Health and Disease and International Development Symposium from XII International Congress of Nutrition. 1981; 739–746.

    Google Scholar 

  25. Poskitt EME. Clinical problems related to the use of drugs in malnutrition. Proc Nutr Soc 1974; 33: 203–207.

    Article  CAS  Google Scholar 

  26. Mora RJF. Malnutrition: organic and functional consequences. World J Surg 1999; 23: 530–535.

    Article  CAS  Google Scholar 

  27. Krishnaswamy K. Nutrition and drug metabolism. Indian J Med Res 1978; 68: 109–120.

    Google Scholar 

  28. Mehta S. Malnutrition and drugs: Clinical implications. Dev Pharmacol Ther 1990; 15: 159–165.

    Google Scholar 

  29. Crook MA, Hally V, Panteli JV. The importance of the refeeding syndrome. Nutrition 2001; 17: 632–637.

    Article  CAS  Google Scholar 

  30. Williams L, Hill DP, Davis JA, Lowenthal DT. The influence of food on the absorption and metabolism of drugs: an update. Eur J Drug Metab Pharmacokinet 1996; 21: 201–211.

    Article  CAS  Google Scholar 

  31. Lieber CS. Alcohol: Its metabolism and interaction with nutrients. Annu Rev Nutr 2000; 20: 395–430.

    Article  CAS  Google Scholar 

  32. Leo MA, Lowe N, Lieber CS. Interaction of drugs and retinol. Biochem Pharmacol 1986; 35: 3949–3953.

    Article  CAS  Google Scholar 

  33. Gunther T, Rebentisch E, Vormann J, Konig M, Issing H. Enhanced ototoxicity of gentamicin and salicylate caused by Mg deficiency and Zn deficiency. Biol Trace Elem Res 1988; 16: 43–50.

    Article  CAS  Google Scholar 

  34. K. Kohli, Aggarwal KK, Bhatt IN. The pharmacokinetic profile of chloramphenicol in protein-malnourished rats. India J Med Res 1981; 73: 208–217.

    CAS  Google Scholar 

  35. Smith JA, Butler TC, Poole DT. Effect of protein depletion in guinea-pigs on glucuronate conjugation of chloramphenicol by liver microsomes. Biochem Pharmacol 1973; 22: 981–983.

    Article  CAS  Google Scholar 

  36. Thabrew MI, Emerole GO, Olorunsogo OO. Effect of chloramphenicol on hepatic mitochondrial and microsomal functions in protein-energy malnourishment. Res Commun Chem Pathol Pharmacol 1982; 38: 481–495.

    CAS  Google Scholar 

  37. Brinker KR, Bulger RE, Dobyan DC, et al. Effect of potassium depletion on gentamicin nephrotoxicity. J Lab Clin Med 1981; 98: 292–301.

    CAS  Google Scholar 

  38. Nehru B, Mehta S, Nain CK, Mathur VS. Disposition of sulphadiazine in young rhesus monkeys with protein calorie malnutrition. Intl J Clin Pharmacol Ther Toxicol 1988; 26: 509–512.

    CAS  Google Scholar 

  39. Sodhi CP, Rana SF, Attri S, Mehta S, Yaiphei K, Mehta SK. Oxidative hepatic injury if isoniazidrifampicin in young rats subjected to protein and energy malnutrition. Drug and Chemical Toxicology 1998; 21: 305–317.

    Article  CAS  Google Scholar 

  40. Sodhi CP, Rana SV, Mehta SK, et al. Study of oxidative stress in isoniazid-induced hepatic injury in young rats with and without protein-energy malnutrition. J Biochem Toxicol 1996; 11: 139–146.

    Article  CAS  Google Scholar 

  41. Tranvouez JL, Lerebours E, Chretien P, Fouin-Fortunet H, Colin R. Hepatic antipyrine metabolism in malnourished patients: influence of the type of malnutrition and course after nutritional rehabilitation. Am J Clin Nutr 1985; 41: 1257–1264.

    CAS  Google Scholar 

  42. Ramesh R, Kalamegham R, Chary AK, Krishnaswamy K. Hepatic drug metabolizing enzymes in undernourished man. Toxicology 1985; 37: 259–266.

    Article  Google Scholar 

  43. Mehta S, Nain CK, Sharma B, Mathur VS. Disposition of four drugs in malnourished children. DrugNutr Interact 1982; 1: 205–211.

    CAS  Google Scholar 

  44. Schenker S, Speeg KV, Perez A, Finch J. The effects of food restriction in man on hepatic metabolism of acetaminophen. Clin Nutr 2001; 20: 145–150.

    Article  CAS  Google Scholar 

  45. Mulholland K, Falade AG, Corrah PT, et al. A randomized trial of chloramphenicol vs trimethoprimsulfamethoxazole for the treatment of malnourished children with community-acquired pneumonia. Pedi Infect Dis J 1995; 14: 959–965.

    Article  CAS  Google Scholar 

  46. Eriksson M, Paalzow L, Bolme P, Mariam TW. Chloramphenicol pharmacokinetics in Ethiopian children of differing nutritional status. Clin Pharmacol 1983; 24: 819–823.

    Article  CAS  Google Scholar 

  47. Ashton R, Boime P, Alemayehu E, Eriksson M, Paalzow L. Decreased chloramphenicol clearance in malnourished Ethiopian children. Clin Pharmacol 1993; 45: 181–186.

    Article  CAS  Google Scholar 

  48. Raghuram TC, Krishnaswamy K. Pharmacokinetics and plasma steady-state levels of doxycycline in undernutrition. Br J Pharmacol 1982; 14: 785–789.

    Article  CAS  Google Scholar 

  49. Bravo ME, Arancibia A, Jarpa S. Carpentier PM, Jahn AN. Pharmacokinetics of gentamicin in malnourished infants. Eur J Clin Pharmacol 1982; 21: 499–504.

    Article  CAS  Google Scholar 

  50. Samotra K, Gupte S, Raina RK. Pharmacokinetics of gentamicin in protein-energy malnutrition. Eur J Clin Pharmacol 1985; 29: 255–256.

    Article  CAS  Google Scholar 

  51. Buchanan N, Davis MD, Eyberg C. Gentamicin pharmacokinetics in kwashiorkor. Br J Clin Pharmacol 1979; 8: 451–453.

    Article  CAS  Google Scholar 

  52. Ronchera-Oms CL, Tormo C, Ordovas JP, Abad J, Jimenez NV. Expanded gentamicin volume of distribution in critically ill adult patients receiving total parenteral nutrition. J Clin Pharm Ther 1995; 20: 253–258.

    Article  CAS  Google Scholar 

  53. Di Palo S, Ferrari G, Castoldi R, et al. Effectiveness of antibiotic prophylaxis according to the nutritional status in patients undergoing contaminated procedures. Ital J Surg Sci. 1988; 18: 223–226.

    Google Scholar 

  54. Mehta S, Nain CK, Sharma B, Mathur VS. Metabolism of sulfadiazine in children with protein calorie malnutrition. Pharmacology 1980; 21: 369–374.

    Article  CAS  Google Scholar 

  55. Shastri RA Krishnaswamy K. Metabolism of sulphadiazine in malnutrition. Br J Clin Pharmacol 1979; 7: 69–73.

    Article  CAS  Google Scholar 

  56. Shastri RA Krishnaswamy K. Undernutrition and tetracycline half-life. Clin Chim Acta 1976; 66: 157–164.

    Article  Google Scholar 

  57. Kitt TM,Park GC, Spector R, Lawton W, Tsalikian E. Renal clearance of oxipurinol and inulin on an isocaloric, low protein diet. Clin Pharmacol Ther 1988; 43: 681–687.

    Article  Google Scholar 

  58. Berlinger WG, Park GD, Spector R. The effect of dietary protein on the clearance of allopurinol and oxypurinol. N Engl J Med 1985; 313: 771–776.

    Article  CAS  Google Scholar 

  59. Park GD, Berlinger W, Spector R, Kitt TM, Tsalikian E. Sustained reductions in oxipurinol renal clearance during a restricted diet. Clin Pharmacol Ther 1987; 41: 616–621.

    Article  CAS  Google Scholar 

  60. Kitt TM, Park GD, Spector R, Tsalikian E. Reduced renal clearance of oxypurinol during a 400 calorie protein-free diet. J Clin Pharmacol 1989; 29: 65–71.

    Article  CAS  Google Scholar 

  61. Tulpule A, Krishnaswamy K. Chloroquine kinetics in the undernourished. Eur J Clin Pharmacol 1984; 24: 273–276.

    Article  Google Scholar 

  62. Eriksson M, Bolme P, Habte D, Paalzow L. INH and streptomycin in Ethiopian children with tuberculosis and different nutritional status. Acta Paediatr Scand 1988; 77: 890–894.

    Article  CAS  Google Scholar 

  63. Polasa K, Murthy KJR, Krishnaswamy K. Rifampicin kinetics in undernutrition. Br J Clin Pharmacol 1984; 17: 481–484.

    Article  CAS  Google Scholar 

  64. Seifart HI, Donald PR, De Villiers JN, Parkin DP, Jaarsveld PP. Isoniazid elimination kinetics in children with protein-energy malnutrition treated for tuberculous meningitis with a four-component antimicrobial regimen. Ann Tropical Paediatrics 1995; 15: 249–254.

    CAS  Google Scholar 

  65. Gersema LM, et al. The effect of dietary protein-calorie restriction on the renal elimination of cimetidine. Clin Pharmacol Ther 1987; 42: 471–475.

    Article  CAS  Google Scholar 

  66. http://www.nhlbi.nih.gov/guidelines/obesity viewed 8/17/02.

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer Science+Business Media New York

About this chapter

Cite this chapter

Compher, C.W. (2004). The Impact of Protein-Calorie Malnutrition on Drugs. In: Boullata, J.I., Armenti, V.T. (eds) Handbook of Drug-Nutrient Interactions. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-781-9_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-781-9_5

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-5359-2

  • Online ISBN: 978-1-59259-781-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics