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IFMCP > Environmental APM > Flashcards

Environmental APM Flashcards

1
Q

phase I: bioactivation

A

oxidation, reduction, hydrolysis
metabolites are more polar, may activate inert compounds
CYP450 - heme/iron dependent

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2
Q

phase II: conjugation

A

metabolites are metabolically inactive, water-soluble, excreted through bile or urine

  • glucoronidation (UGT)
  • sulfonation (SULT)
  • glutathione conjugation
  • methylation
  • amino acid conjugation
  • acetylation
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3
Q

Gilbert’s syndrome SNP

A

UGT

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4
Q

Gilbert’s syndrome presentation

A

jaundice after fasting (due to inability to conjugate bilirubin with glucuronic acid)

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5
Q

which drug harder to metabolize in Gilbert’s

A

acetaminophen

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6
Q

food group that is supportive in Gilbert’s

A

cruciferous

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7
Q

body burden

A

quantity of exogenous substances or metabolites that accumulate in individual

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8
Q

enterohepatic recirculation

A

cycling of drugs, xenobiotics, metabolites after excretion into biliary system, which are then reabsorbed in intestine

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9
Q

does fasting impact phase I or II more?

A

phase II

it can decrease sulfonate and glucuronidation

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10
Q

lab tests to reveal toxicity

A

CBC - leukopenia, anemia
8-OH DG - indicates damaged DNA
blood lead, arsenic, cadmium, mercury
GGT (also AST, ALT) - xenobiotic exposure

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11
Q

lab measures of antioxidant status

A 
GSH, GSH peroxidase, SOD
RBC Zn, Mag, Se
EFA
coQ10 (total and reduced)
retinol
tocopherols
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12
Q

biomarkers of susceptibility in stool/GI

A

decreased diversity, dysbiosis, IP, elevated beta glucuronidase

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13
Q

lab measures of oxidative stress

A 
8-OHDG
TBARS
ORAC - oxygen radical absorbance capacity
lipid peroxides
F2 isoprostanes
oxLDL
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14
Q

testing for heavy metals

A

blood is best for recent exposure (4-6 weeks) or recent mobilization
blood and urine can both be used for acute or chronic
hair best used WITH blood and urine

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15
Q

heavy metal found in hair of those with ASD

A

Antimony, Lead, Mercury, Arsenic

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16
Q

heavy metal found in hair of those with ADHD, ODD

A

Manganese, Lead, Mercury, Aluminum

17
Q

heavy metal found in hair of those with depression

A

lead

18
Q

utility of fecal samples of heavy metal

A

elimination of mercury DURING therapy (children, elderly)

19
Q

Supportive nutrients for phase I

A 
B2
B3
B6
folic acid
B12
GSH
phospholipids
Mag, Zn, Cu
iron (CYP450s)
Mb
flavonoids
20
Q

Supportive nutrients for phase II

A 
cysteine
Sulfate
N-acetylcysteine
Methionine, serine
glycine, taurine
glutamine, proline
ornithine, arginine
Riboflavin
Vitamin A
Methyl donors (folate, choline, TMG, SAMe)
Phytonutrients
21
Q

SMART

Safe Mercury Amalgam Removal Technique

A 
pre-tx with ingested charcoal + chlorella rinse
nasal air supply for patient
dental dam + nitrile gloves
saliva ejector under dam
eye protection for pt
"clean-up" suction devices
PPE and Hg-sp masks for dental team
22
Q

oral health preventative strategies

A

Diet - Avoid allergies/intolerances, nutrient to support detox, Detox Food Plan
physical biofilm disruption
BPA free dental materials
eliminate toxic oral health products (SLS, triclosan, propylene glycol, fluoride)
probiotics

23
Q

4 primary amino acids in phase II aa conjugation

A

glycine, taurine, arginine, glutamine

24
Q

phytochelators

A 
inulin
modified citrus pectin
oat fiber
taurine
wheat and rice bran
chlorella
25
Q

estrogen phase I support

A

I3C, DIM, soy, lignan

26
Q

estrogen phase II COMT support

A

Mag, SAMe, folate/B12, choline, TMG (trimethylglycine)

27
Q

estrogen phase II SULT support

A

genistein, vit A and E, Se, cruciferous

28
Q

estrogen phase II UGT support

A

Mag, curcumin, quercetin, calcium d glucurate, probiotics

29
Q

green tea

A

inhibits certain phase I and induces certain phase II enzymes

30
Q

oral health antecedent examples

A

root canal, jaw osteonecrosis, xerostromia, mercury amalgams

31
Q

oral health trigger examples

A

removing mercury, periodontal dz, root canal tx/failure, extraction/implants

32
Q

oral health mediator examples

A

mercury amalgams, oral/jaw infection, mixed metals, jaw osteonecrosis

33
Q

PURE

A

Pattern Recognition - mouth/dental exam, ID toxic exposure, pt sensitivity, autoimmune/CVD/DM

Undernourished - esp vit D, K2, C, E, B vitamins, Se, CoQ10, Zn, Ca

Reduce Exposure - from food, remove amalgams before chelation

Ensure a Safe Detox

IFMCP (9 decks)

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