Wellness Flashcards
(102 cards)
1
Q
It is thought that more time at home leads to…
A
more screen time and less outdoor physical activity = obesity
2
Q
Quarantine issues:
A
- lack of sleep
- altered eating habits
- decreased physical activity
3
Q
BMI utilizes a person’s…
A
height and weight
4
Q
How to find BMI:
A
kg/m2 or (lbs/in2)x703
5
Q
Overweight people have a BMI of…
A
25-29.9 kg/m2
6
Q
Obese people have a BMI of…
A
30 or greater
7
Q
Class 1 obesity has a BMI of…
A
30-34.9
8
Q
Class 2 obesity has a BMI of…
A
35-39.9
9
Q
Class 3 obesity has a BMI of…
A
over 40
10
Q
BMI has limitation b/c of…
A
very muscular individuals
11
Q
Instead of just relying on BMI, we can also consider…
A
measuring waist circumference
12
Q
What waist circumference for males and females indicates that they are at risk for CVD and type 2 diabetes?
A
- males: over 40
- females: over 35
13
Q
How to measure waist circumference:
A
- stand and place tape measure along belly button (above hipbones)
- tape should be horizontal and snug around waist
- look at number just after breathing out
14
Q
Associated chronic health problems:
A
- cerebrovascular disease/stroke
- hypertension
- type 2 diabetes
- osteoarthritis
- sleep apnea
15
Q
Obesity has the most effect on what health problem?
A
diabetes
16
Q
Medications associated w/ weight gain:
A
- 2nd generation antipsychotics
- antidepressants
- hormonal contraceptives
- corticosteroids
- anticonvulsants
- insulin/sulfonylureas/thiazolidinediones
17
Q
Initial goal of weight loss is to reduce body weight by…
A
5-10% over 6 months or by 1-2 pounds per week
18
Q
What is the mainstay for weight loss therapy?
A
dietary modification or restriction
19
Q
Exercise is less efficient _____, but important for ______
A
initially, maintenance and improving overall fitness
20
Q
Reduced calorie diet and increased physical activity leads to…
A
greater weight loss and reduction of abdominal fat
21
Q
Obesity/overweight management is only recommended as adjunct therapy to lifestyle interventions if BMI is…
A
over 30 kg/m2 or over 27kg/m2 w/ diseases or risk factors
22
Q
OTC orlistat 60mg can be used if…
A
BMI is over 25 kg/m2
23
Q
MOA of orlistat:
A
- reversible inhibitor of gastric and pancreatic lipases, which stops hydrolysis of TGs
- inhibits 30% of dietary fat absorption
24
Q
OTC dose of orlistat:
A
60 mg capsule
- approved for ages > 18
- take TID before meals that have fat
25
Orlistat has been shown to have a weight loss of...
5-10 lb within 6 months and significant decrease in LDL cholesterol and blood pressure
26
Side effects of Orlistat:
- fatty/oily stool
- loose and frequent stools
- fecal urgency and incontinence
- intestinal gas with discharge
27
Orlistat decreases the...
absorption of fat soluble vitamins (ADEK)
| - should take multivitamin at bedtime or separate at least 2 H from orlistat dose
28
Orlistat:
- minimally absorbed
- little systemic toxicity
- drug interactions unlikely
- warning of potential liver injury
29
Complementary therapies for obesity:
- usually not FDA approved
- lack scientific evidence
- botanical names not listed
- associated w/ serious adverse effects
30
Examples of complementary therapies for obesity:
- stimulants/E boosters
- fat/carb modulators
- laxatives
31
Examples of stimulants/E boosters:
- bitter orange
| - caffeine
32
Examples of fat/carb modulators:
- green tea
- coffee
- chromium
33
Examples of laxatives:
- psyllium
- cascara sagrada
- casanthranol
- phenolphthalein
34
Stimulants/E boosters increase...
basal metabolism
35
Adverse effects of bitter orange:
- hypertension
- CV toxicity
- MI
- stroke
- seizure
36
Adverse effects of caffeine:
- GI distress
- headaches
- insomnia
- anxiety
- decreased appetite
- hypertension
37
Fat/carb modulators alter...
fat or carb metabolism, which leads to decreased body fat mass and increased lean muscle mass
38
Adverse effects of chromium:
- mood and sleep changes
- headaches
- cognition and perception dysfunction
39
Laxatives increase...
fecal loss
40
Adverse effects of laxatives:
- electrolyte imbalances
- can cause dependence
- severe cramping
41
Treatment goals of osteoporosis and osteopenia:
- maintain skeletal and bone mass
- prevent age-related bone loss
- optimize skeletal development
- avoid falls and fractures
42
Risk factors for osteoporosis and osteopenia:
- > 50 YO
- women more than men due to menopause
- smoking
- low calcium diets
- eating disorders
- family history
- low body weight
- sedentary lifestyle
- previous broken bones
- hormone imbalances
43
Calcium replacement as therapy for osteoporosis and osteopenia:
- aids in bone development/growth
- maintains overall bone strength
- often used in combo w/ vitamin D, which assists w/ reabsorption of calcium
44
Recommended dietary allowance of calcium and vitamin D for 19-50 YO:
- calcium: 1,000 mg
| - vitamin D: 600 units
45
Recommended dietary allowance of calcium and vitamin D for 51-70 YO male:
- calcium: 1,000 mg
| - vitamin D: 600 units
46
Recommended dietary allowance of calcium and vitamin D for 51-70 YO female:
- calcium: 1,200 mg
| - vitamin D: 600 units
47
Recommended dietary allowance of calcium and vitamin D for > 70 YO:
- calcium: 1,200 mg
| - vitamin D: 800 units
48
Common doses for calcium:
- body can only absorb in small doses
| ex: 45 YO female would need to take 500 mg BID, not 1,000 mg QD
49
Adverse effects for calcium:
- GI distress
- constipation
- headache
- increased risk for kidney stones
50
Vitamin D:
- can be found as IU or mcg
| - mcg x 140 = IU
51
Adverse effects of vitamin D:
- hypercalcemia
- hypercalciuria
- headache
- nausea
- weakness
- usually well tolerated
52
Types of calcium:
- carbonate
- phosphate
- citrate
53
Dosage of carbonate:
200-500 mg
| - take w/ food to enhance absorption
54
Absorption of carbonate:
- not well absorbed
- water insoluble
- optimal in low pH environments
55
Dosage of phosphate:
600 mg
56
Absorption of phosphate:
- best absorbed
| - water insoluble
57
Dosage of citrate:
200 mg
58
Absorption of citrate:
- acid not required
- water soluble
- preferred for patients on PPIs or histamine-2 antagonists (H2RAs)
59
Dosage forms of calcium:
- chewable tabs
- coated tabs
- gummies
- liquid
- soft chews
60
Insomnia:
- difficulty falling or staying asleep
- waking up too early and not returning to sleep
- not feeling refreshed after sleeping
61
Types of duration for insomnia:
- transient
- short-term
- chronic/long-term
62
Transient insomnia is...
- self limiting (< 1 week)
63
Causes of transient insomnia:
- traveling
- hospitalization
- studying for exam
64
Short-term insomnia lasts...
1-3 weeks
65
Causes of short-term insomnia:
- personal tragedy
| - surgery recovery
66
Chronic/long-term insomnia lasts...
> 3 weeks to years
67
Causes of chronic/long-term insomnia:
- medical problems
- psychiatric disorders
- substance abuse
68
Classifications of causes for insomnia:
- primary
| - secondary
69
Primary cause for insomnia:
- sleep difficulty for at least 1 month
- affects psychosocial functioning
- not caused by secondary disorders
70
Secondary cause for insomnia:
- sleep, medical, or psych disorders
| - medications
71
Recommended sleep requirement for > 18 YO:
8 hours
72
Patients w/ symptoms of insomnia lasting _______ should be referred to PCP
over 4 weeks
73
Self care exclusions to insomnia:
- patients ages < 12 or > 65
- pregnancy
- frequent nighttime or early morning awakenings w/ difficulty falling back to sleep
- chronic insomnia
- sleep disturbances due to meds
74
OTC medications that can worsen insomnia:
- antihistamines (1st gen)
- caffeine
- decongestants
- nicotine
- valerian
75
Sleep hygiene:
- use bed for sleeping or intimacy
- establish regular sleep pattern
- avoid eating meals w/in 2 hours of bedtime
- avoid caffeine, alcohol, or nicotine w/in 4-6 hours before bed
76
Pharmacologic therapy for insomnia:
- diphenhydramine
| - doxylamine
77
Diphenhydramine is the...
only FDA approved sleep aid proven to be safe and effective
78
Indication for diphenhydramine:
symptomatic management of transient and short-term sleep difficulty
79
Dosage for diphenhydramine:
50 mg QHS
- max sedation 3-6 hours after dose
- take 30 minutes before bed
- intermittent use for 3 days: take one night without med
80
Side effects of diphenhydramine:
- dry mouth
- dizziness/falls
- blurred vision
- constipation
- sedation
81
Warnings of diphenhydramine:
- no alcohol
- max use of 7-10 consecutive nights
- no driving or cooking until patient response is known
- no elderly
82
Doxylamine:
safety and efficacy is not established by FDA
83
Dosage for doxylamine:
25 mg taken 30 minutes before bed
84
Side effects of doxylamine:
- dry mouth
- dizziness/falls
- blurred vision
- constipation
- sedation
- same as diphenhydramine
85
Examples of complementary therapies for insomnia:
- melatonin
| - valerian
86
Dosage for melatonin:
0.5-5 mg given 30-60 minutes before bed
87
Evening doses of melatonin advance...
circadian rhythm andinduce onset of sleep
88
Melatonin is induced by ___ and suppressed by ___
darkness, light
89
Side effects of melatonin:
- reduced focus and concentration
| - lower body temp
90
Dosage for valerian:
400-900 mg given 30-120 minutes prior to bed
91
Continuous use of valerian for _____ required for best effects
several days/weeks
92
For valerian, patients should avoid:
kava
93
Drowsiness:
feeling of falling asleep
94
Fatigue:
weakness or exhaustion
95
Drowsiness and fatigue are caused by...
- inadequate sleep
- use of CNS depressants
- depression
- cancer
- hypothyroidism
- chronic pain
96
Examples of CNS depressants:
- antihistamines
- antipsychotics
- anticonvulsants
- opioids
97
Caffeine:
- pharmacological way to treat drowsiness and fatigue
- only FDA approved nonrx stimulant
- nonselective adenosine antagonist
- well absorbed
98
Dosage for caffeine:
100-200 mg Q3-4H prn for > 12 YO
99
Peak action of caffeine occurs within...
30-75 minutes
100
Side effects of caffeine:
- GI distress
- headaches
- insomnia
- restlessness
- agitation
- decreased appetite
- increased urination
- dehydration
101
High doses of caffeine ( > 400 mg) causes...
- dysrhythmias
- palpitations
- tachyarrhythmia
102
Warnings of caffeine:
- anxiety
- CV disease
- GI diseases
- hepatic/renal impairment
- seizure disorders
- pregnancy
