Lesson 6 Flashcards
(18 cards)
How many adults in the US have chronic disease?
Six in ten; four in ten have two or more
Biggest risk factors for chronic disease
Tobacco use
Physical inactivity
Unhealthy diet
Alcohol use
Pillars of Lifestyle Medicine
Effective prevention against chronic conditions:
1) Healthy eating
2) Healthy relationships
3) Quality sleep
4) Avoiding substances
5) Managing stress
6) Physical activity
Pathophysiology of T2DM
Beta cells dysfunction in the pancreas / insulin resistance occurs in the liver, skeletal muscle and adipose tissue –> hyperglycemia
Insulin either not created / absorbed, impairs glucose uptake
Lifestyle Factors in T2DM
Unhealthy diet and physical inactivity leads to increased adiposity –> low grade inflammation in the pancreas and stress on beta cells –> beta cell dysfunction in pancreas and insulin resistance in liver / muscle –> excess glucose production, impaired glucose uptake and utilization
Increasing exercise can increase glucose uptake and decrease insulin resistance
Sleep deprivation can cause inflammation in tissues, hypertrophy in adipose tissue and breakdown of skeletal muscle –> increases risk of Type 2 DM
Whole Grains in T2DM
Bran and fiber slow breakdown of starch into glucose –> steady blood sugar instead of spikes
Fiber lowers cholesterol, moves waste through digestive tract and prevents small blood clots
SMART Goals
Specific
Measurable
Attainable
Relevant
Time-Based
Moral Theory of Addiction
Bad choices based on antisocial values
Nature Theory of Addiction
Dysregulation of innate desire to alter consciousness
Psychology Theory of Addiction
Coping, learning, reinforcement, personality
Sociology Theory of Addiction
Family, environment, culture, education
Disease Theory of Addiction
Compulsive use despite negative consequences based on genetics, volition on first use, and neurological pathways that reinforce use
DSM-5 Criteria
Must have 2 over last year causing clinically significant impairment or distress
Withdrawal
Craving
Control, failed attempts
Health
Hazardous situations
Activities, giving up normal
Amounts, using for greater time than planned
Roles (home, school, work)
Relationships
Tolerance
Time (spending an inordinate amount)
Role of Dopamine
Thought to be just pleasure; now associated with salience and reinforcement
Drugs cause a spike in dopamine, causing addict to be unable to perceive normal amounts of pleasure and salience from everyday things. Frontal cortex not functioning, stress-hedonic system broken.
Methadone Therapy
Full agonist that acts on mu, kappa and delta opioid receptors. Long half-life.
Can cause respiratory depression at high doses.
Does not cause severe dopamine spikes, within normal level. Pt is not high, but stops withdrawal –> stops cravings –> stops using.
Buprenorphine Therapy
Partial agonist with a plateau effect. Safer, minimal respiratory depression.
Very high receptor affinity with long half life, can kick out opioids from receptors.
Naloxone / Naltrexone Therapy
Full antagonist
Precipitated Withdrawal
Very sudden, severe withdrawal when buprenorphine kicks other opioids out of the receptors. Microdosing can gradually replace receptors, less precipitated withdrawal.
