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OTC > HTN, dyslipidemia, and obesity > Flashcards

HTN, dyslipidemia, and obesity Flashcards

1
Q

when to refer for hypertension and dyslipidemia

A
  1. no formal diagnosis
  2. no visit to PCP in last year
  3. nonadherence to medications
  4. perception that Rx medications are ineffective
  5. use of dietary supplements without PCP knowledge
  6. concurrent medication
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2
Q

medications that can worsen HTN

A

amphetamines, decongestants, erythropoietin, estrogen derivatives, nicotine, NSAIDs, corticosteroids, venlafaxine

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3
Q

lifestyle habits that can worsen HTN

A

increased caffeine, sodium, alcohol intake, decreased physical activity, and tobacco use

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4
Q

DASH diet reduces systolic by

A

8-14 mmHg

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5
Q

reducing weight reduces systolic by

A

5-20 mmHg

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6
Q

increase in physical activity reduces systolic by

A

4-9 mmHg

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7
Q

reduce intake of dietary sodium reduces systolic by

A

2-8 mmHg

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8
Q

consuming alcohol in moderation reduces systolic by

A

2-4 mmHg

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9
Q

non pharm treatment for pts w dyslipidemia

A

exercise, diet, smoking cessation, and limiting alcohol consumption

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10
Q

who should not be doing home cholesterol tests

A

excessive bleeding from a finger stick can occur in patients who have coagulation disorders or use anticoagulants, do not recommend for pt who have health insurance or see PCP annually

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11
Q

who benefits from home cholesterol tests

A

more beneficial for those who don’t have insurance, those who don’t see PCP annually, or who have high cost or no lab coverage

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12
Q

fish oil MOA

A

reduce intestinal absorption of cholesterol and inhibit VLDL –> reduction of TG synthesis in liver –> reduce concentration of TG

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13
Q

fish oil therapeutic uses

A

lower TG levels (25-50%), hyperlipidemia, CAD, HTN, and inflammatory conditions

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14
Q

dosing of fish oil

A

1-2g per day, for TG lowering 2-4g per day

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15
Q

common AE of fish oil

A

fishy smell, fishy burps, and/or upset stomach

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16
Q

doses of fish oil up to ______ considered safe in patients with anticoags

A

3g/day

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17
Q

therapeutic use of red yeast rice

A

mainly lowers LDL with some effect on TG, improves indigestion and blood circulation

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18
Q

MOA of red yeast rice

A

composed of monacolins which inhibit HMGCoA reductase

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19
Q

dosing of red yeast rice

A

1.2 to 2.4g/day in two divided doses with food

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20
Q

ADE of red yeast rice

A

allergic reactions, headache, and GI upset

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21
Q

red yeast rice may cause

A

elevated liver enzymes or rhabdomyolysis similar to statins

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22
Q

alcohol > 2 drinks/day and red yeast rice

A

increased risk of hepatotoxicity

23
Q

pregnancy and red yeast rice

A

category X

24
Q

therapeutic uses for niacin

A

dyslipidemia, hypertriglyceridemia

25
Q

MOA of niacin

A

inhibits mobilization of FFA from fat tissue to the liver –> reduce VLDL –> reduction in LDL and TG levels and increase HDL levels

26
Q

dosing of niacin

A

1-3 g/day typically divided; start at lower dose and titrate

27
Q

side effects of niacin

A

Flushing (IR > ER > SR)
hyperglycemia (SR > ER > IR)
hepatotoxicity (SR > ER > IR)
GI symptoms

28
Q

contraindications of niacin

A

liver disease, active peptic ulcer

29
Q

co-enzyme Q10 therapeutic use

A

heart failure, cardiomyopathy, HTN, antioxidant, statin-related myopathy

30
Q

MOA of Q10

A

involved in many energy production functions. also involved with regeneration of antioxidants such as vitamin E, stabilizes membranes and may have vasodilator and inotropic effects

31
Q

typical dosage of coQ10

A

100mg dosed 1-3 times daily

32
Q

side effects of coQ10

A

nausea, GI upset, headache

33
Q

BMI

< 18.5

A

underweight

34
Q

BMI

18.5-24.9

A

normal

35
Q

BMI

25.0-29.9

A

overweight

36
Q

BMI

30.0-34.9

A

class I obesity

37
Q

BMI

35.0-39.9

A

class II obesity

38
Q

BMI

40 or higher

A

class III obesity

39
Q

exclusions for obesity

A
  1. BMI 40 or higher
  2. pregnancy or breast-feeding
  3. < 18 y/o OR > 65 y/o
  4. CV disease, diabetes, hypertension, dyslipidemia
  5. eating disorders
40
Q

non pharm treatment for obesity

A

caloric restriction, dietary changes, altered proportions of food groups/diets, commercial weight loss-programs, exercise

41
Q

alli moa

A

reversible lipase inhibitor

- inhibits 25% absorption of dietary fat intake

42
Q

alli dosage

A

60 mg capsule > 18 y/o (take one capsule TID)

43
Q

alli ADE

A

flatulence with oily spotting/leakage, oily diarrhea, fecal urgency

44
Q

MVI and alli

A

one time daily at bedtime or at least 2 hours AFTER alli

45
Q

alli contraindications

A
  1. organ transplant OR taking cyclosporine
  2. pregnant or breast feeding
  3. chronic malabsorption syndrome
  4. cholestasis
46
Q

stimulants, energy boosters, thermogenic aids

A

increase basal metabolism, increase energy, counteract fatigue
(bitter orange, caffeine)

47
Q

fat and carb modulators

A

alter fat or carbohydrate metabolism, resulting in decreased body mass and increased lean muscle mass
(green tea, chromium, carcinia)

48
Q

appetite suppressants and satiety promoters

A

reduce caloric intake by suppressing appetite or promoting satiety
(guar gum, glucomannan, psyllium)

49
Q

fat absorption blockers

A

block intestinal absorption of dietary fats

chitosan, green coffee, raspberry ketones

50
Q

cortisol blockers

A

block stress-induced release of cortisol to avoid cortisol-induced increased appetite and fat storage
(beta-sitosterol, phosphatidylserine, theanine)

51
Q

carbohydrate absorption blockers

A

block intestinal absorption of dietary carbohydrates

kidney bean extract, mung bean extract

52
Q

laxatives

A

promote weight loss by increasing fecal loss

cascara Sagrada, psyllium

53
Q

Diuretics

A

promote weight loss by increasing urination and fluid loss

dandelion, caffeine

OTC (22 decks)

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