Etc Flashcards
What is the indication for taking fish oil/omega 3 supplement?
Hypertriglyceridemia
What is the mechanism of action of fish oil/omega 3?
Decrease in hepatic secretion of VLDL-C, increase VLDL-C clearance, reduces TG transport.
What pathways do omega-3 fatty acids compete with?
Compete with arachidonic acid in the cycloxygenase and lipoxygenase pathways
What are the drug interactions of fish oil?
Antihypertensives, contraceptives, and orlistat
What are the herb interactions of fish oil?
The Gs: Garlic, ginger, ginkgo, and ginseng
What are the indications for niacin?
Dyslipidemia
What are the effects of niacin supplement?
Decrease LDL and TG, increase HDL
What are some major side effects of niacin?
Flushing, GI effects, increase blood glucose and uric acid (contraindicated in gout)
What is the MOA of plant sterols?
Inhibits about 50% intestinal absorption of cholesterol
What is the MOA of plant stanols?
Inhibits dietary and biliary cholesterol
What are the effects of plant sterols?
Lowers TC and LDL-C, no effect on HDL
What are the effects of plant stanols?
Lowers LDL-C
What are the side effects of plant sterols?
GI effects
What are the side effects of plant stanols?
Diarrhea and steatorrhea
What are the drug interactions of plant sterols and stanols?
Beta carotene and VitE, Zetia
Which are more effective: plant sterols or stanols?
Equally effective
What is the efficacy of Ephedra?
Weight loss of 0.9 kg/month up to 6 months with
What are the adverse reactions of Ephedra?
Dizziness, anxiety, dry mouth, tachycardia, HTN, seizures, cardiomyopathy, MI, arrhythmia, and sudden death.
What is the MOA of bitter orange?
Contains 6% of synephrine (related to ephedrine)
What are the adverse effects of bitter orange?
Same as Ephedra
What is the efficacy of taking in more Ca in the diet?
Weight loss
What are the drug interactions of orlistat?
Anticoagulants, amiodarone, levothyroxine, and vitamins (absorption).
Which organ can orlistat damage?
Liver
Which types of patients take chromium supplements?
Diabetes patients
What is the MOA of chromium?
Might reduce oxidative stress. Reduces HbA1C.
What are the adverse reactions of chromium?
HA, insomnia, irritability, mood changes, sleep disturbances, vomiting, diarrhea, hemorrhage
What is the MOA of vanadium?
Activates insulin R proteins, stimulates glucose oxidation and transport. Stimulates glycogen synthesis in liver. Inhibits lipolysis in adipose tissue. Promotes glucose uptake in skeletal muscle.
What are the adverse reactions of vanadium?
GI upset, kidney toxicity, fatigue, lethargy and tongue discoloration.
What are the indications for garlic supplements?
Hypertension and dyslipidemia
What is the MOA of garlic?
Allicin is the active ingredient. Inhibits hepatic cholesterol synthesis. Activates production of endothelium-derived relaxation factor to relax SM and vasodilate.
What are the indications for coenzyme Q-10?
CHF and prevention of statin-induced myopathy
What is the MOA of coenzyme Q-10?
Antioxidant properties to stop damage and give energy to cells. Cofactor in metabolic pathways.
What is the major drug interaction of coenzyme Q-10?
Anticoagulants (increased risk for bleeding)
What is the major lab interaction of coenzyme Q-10?
Increased T4/T8 ratio in normal patients
What are the disease interactions of coenzyme Q-10?
May lower BP, cigarette smoking may deplete body stores
How do you determine the mid-parental height for a boy?
[mother’s height (+5in or 13cm) + father’s height] / 2
How do you determine the mid-parental height for a girl?
[father’s height (-5in or 13cm) + mother’s height] / 2
Define constitutional growth delay
aka “late bloomers.” Growth deceleration during first 2 years of life followed by normal growth paralleling lower percentile curve. Delayed skeletal maturation.
Define familial short stature
North growth velocity and height that are within normal limits for parent’s heights
Define failure to thrive
Infants or young children (
Define nutritional growth retardation
Same as FTT but in those > 3 YO
How can stimulant medications lead to nutritional growth retardation?
Decrease in appetite
Define children born small for gestational age
Less than - 2SD for birth weight or length
What percentage of children who are small for gestational age remain short as adults?
10%
When is it best to do the newborn screening?
3-5 days of life
If T3 uptake and T4 are in the same direction, what does this indicate?
Thyroid disease - Low uptake and low T4 is hypothyroidism
If T3 uptake and T4 are in opposite directions, what does this indicate?
d
What is the pathophysiology of osteomalacia and rickets?
The calcium phosphate product is not adequate to mineralize the osteoid that is formed in bone
What is Paget’s disease?
An idiopathic bone condition characterized by excessive/unregulated bone resorption and formation.
What are the CV clinical features associated with Paget’s disease?
Atherosclerosis, aortic stenosis, and CHF
What are osteoclastic lab markers?
NTX/CTX
