University of Pennsylvania, Philadelphia, PA, USA.
J Clin Pharm Ther. 2013 Aug;38(4):269-71. doi: 10.1111/jcpt.12075. Epub 2013 May 27.
The management of drug-drug interactions - from recognition of the interaction potential, to addressing the negative consequences - are well-recognized and avoided, or rapidly addressed when identified clinically. Drug-nutrition interactions are no less important than drug-drug interactions in patient care. Unfortunately, beyond those caused by food, these interactions are less commonly recognized or identified and managed. This article will re-introduce the topic of drug-nutrition interactions to clinicians.
Although many clinicians are acutely aware of and vigilant for potential drug-drug interactions, most are less aware of the possibility of drug-nutrition interactions beyond classic food-drug interactions. Interaction can occur between a drug and a nutrient, multiple nutrients, food in general, specific foods or components, or nutrition status. An interaction is considered clinically significant if it alters therapeutic drug response and/or compromises nutrition status. Mechanistically the interactions may be physicochemical reactions, actions at membrane transporters or metabolizing enzymes, or an influence on physiologic function. Appreciating the many types of drug-nutrition interactions will aid the clinician and have the potential to influence patient outcome.
Ongoing advances in knowledge about drug and nutrition interactions have potential to improve patient care. Drug-nutrition interactions need to be better recognized, understood on a mechanistic basis, predicted, and managed as necessary.
药物-药物相互作用的管理——从识别相互作用的潜力，到解决负面后果——已经得到了很好的认识和避免，或者在临床上发现时迅速得到解决。药物-营养相互作用在患者护理中与药物-药物相互作用同样重要。不幸的是，除了食物引起的相互作用外，这些相互作用较少被认识或识别，也较少得到管理。本文将向临床医生重新介绍药物-营养相互作用的主题。
尽管许多临床医生敏锐地意识到并警惕潜在的药物-药物相互作用，但大多数临床医生对除了经典的食物-药物相互作用之外的药物-营养相互作用的可能性认识不足。相互作用可能发生在药物和营养素、多种营养素、一般食物、特定食物或成分之间，或者营养状况之间。如果相互作用改变了治疗药物的反应和/或损害了营养状况，则被认为具有临床意义。从机制上讲，相互作用可能是物理化学反应、膜转运体或代谢酶的作用，或者对生理功能的影响。了解许多类型的药物-营养相互作用将有助于临床医生，并有可能影响患者的治疗结果。
关于药物和营养相互作用的知识的不断进步有可能改善患者的治疗效果。需要更好地认识药物-营养相互作用，从机制上理解它们，预测它们，并在必要时进行管理。
