Book Review -- Powers and Moore's Food-Medications Interactions
by Zaneta M. Pronsky

Pottstown, Pennsylvania; 9th edition, 1995 257 pages; $18.95, paper; $189.95, software for Windows

Eating is an essential universal activity. And most individuals consume medications at some time or another. Thus, it is important to know about interactions between food and medications. There are other publications that address this topic, but this book is unique in its format. It includes almost all compounds that are prescribed or purchased over the counter, lists their interactions with food and specific nutrients, cautions against use along with alcohol or during lactation, summarizes important side effects, and suggests methods of monitoring interactions.

The introductory sections describe mechanisms of food-medication interactions, medication kinetics, nutrient kinetics, potential modifications by food of medications' actions, and effects of medications on nutritional status. The introductory material also provides guidelines for counseling medicated patients and dietary suggestions to aid in the relief of nutrition-related side effects of drugs. These introductory pages are very well written and provide a wealth of general information that should be kept in mind along with the specific guidelines and cautions for individual medications.

The bulk of the text lists individual drugs and deals with their interactions with food and nutrients. Most medications are covered adequately. It was obviously not possible to examine the veracity and completeness of the information in each entry. However, the authors have done a wonderful job in preparing a reference book of great practical importance.

A few omissions and errors were noted in the text. There is no mention of precautions that should be taken during pregnancy. The propensity of acetylsalicylic acid to predispose to Reye's syndrome (not Reyes syndrome as written in the book) is enhanced by chicken pox and influenza virus infections, and this is not mentioned. The publication does not indicate that the use of phenytoin is associated invariably with a reduction in serum IgA concentrations. If administered during pregnancy, phenytoin would cause a long-lasting immunodeficiency. For most medications, warnings are given regarding use during lactation, but the potential problems to be expected are not listed. The effect of methylcellulose and many antacids on bioavailability of trace minerals is not mentioned. The interaction of terfanidine with certain antibiotics that can cause life-threatening cardiac arrhythmias is not noted. These are some but not all the omissions and errors that should be corrected in the next edition.

The availability of the material in the form of software provides a quick reference when faced with an emergency situation requiring knowledge of medication-food interactions. All in all, this is a very useful publication, and it is recommended for wider reading and usage.

R. K. Chandra, MD, FRCPC, is professor of pediatric medicine and biochemistry at the Memorial University of Newfoundland, Canada, and director of immunology at the Dr. Charles A. Janeway Child Health Centre.