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Fall 2020: Therapeutics 2 > Metabolic Syndrome > Flashcards

Metabolic Syndrome Flashcards

1
Q

What is metabolic syndrome?

A

Accumulation of several disorders that, together, increase the risk of an individual developing atherosclerotic cardiovascular disease and T2DM

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2
Q

What six disorders can make up metabolic syndrome?

A
  • Prothrombotic state
  • Proinflammatory state
  • Nonalcoholic fatty liver disease
  • Cholesterol gallstones
  • Obstructive sleep apnea
  • Gout
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3
Q

What is the main driver of metabolic syndrome?

A

Obesity (especially abdominal or upper-body obesity)

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4
Q

What is the bottom line pathophysiology for metabolic syndrome?

A
  1. Obesity
  2. Tissue dysfunction
  3. Insulin resistance/neurohormonal activation/chronic inflammation
  4. Metabolic syndrome
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5
Q

What risk factors are associated with metabolic syndrome?

A
  • Insulin resistance
  • Physical inactivity
  • Older age
  • Hormonal imbalance
  • Genetics
  • Race/ethnicity
  • Abdominal obesity
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6
Q

What is the abdominal obesity criteria for metabolic syndrome?

A
  • Waist ≥102 cm (40 inches) in men
  • Waist ≥88 cm (35 inches) in women
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7
Q

What are the triglyceride requirements for metabolic syndrome?

A

≥150 mg/dl or drug treatment

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8
Q

What is the HDL-C range required for diagnosis of metabolic syndrome?

A
  • <40 mg/dl in men or drug treatment
  • <50 mg/dl in women or drug treatment
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9
Q

What is the blood pressure requirement for metabolic syndrome diagnosis?

A

≥130/85 or drug treatment

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10
Q

What is the elevated fasting plasma glucose requirement for metabolic syndrome diagnosis?

A

≥100 mg/dl or drug treatment

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11
Q

What are the three primary treatment goals of metabolic syndrome?

A
  • Decrease ASCVD/T2DM risk
  • Treat underlying disease states
  • Improve lifestyle factors
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12
Q

What is the initial weight loss goal for metabolic syndrome?

A

7-10% weight reduction over 6-12 months

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13
Q

What is the ultimate weight loss goal for metabolic syndrome?

A
  • BMI <25
  • Waist <40 inches in men and <35 in women
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14
Q

By how much should metabolic syndrome patients decrease their caloric intake?

A

500-1000 calories per day

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15
Q

How much aerobic exercise should metabolic syndrome patients get per week?

A

>150 minutes

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16
Q

What resistance training should metabolic syndrome patients do?

A

Single-set repetitions involving major muscle groups on 2-3 days/week

17
Q

What BMI range in underweight?

A

<18.5

18
Q

What is a normal BMI range?

A

18.5-24.9

19
Q

What is an overweight BMI range?

A

25-29.9

20
Q

What BMI range is considered obese?

A

≥30

21
Q

How do you calculate BMI?

A
  • (Weight in lbs x 703) / (height in inches)2
  • (Weight in kg) / (height in meters)2
22
Q

When is weight-loss medication indicated?

A
  • BMI ≥30
  • BMI ≥27 with one of the following: T2DM, CVD, HTN, dyslipidemia, sleep apnea
23
Q

What is the prescription form of Orlistat?

A

Xenical

24
Q

What is the OTC form of Orlistat?

A

Alli

25
Q

What is Orlistat’s mechanism of action?

A

Lipase inhibitor: decreases dietary fat absorption by 30%

26
Q

What adverse drug reactions are associated with Orlistat?

A
  • Cramps
  • Oily stool
  • Flatulence
  • Urgency
  • Diarrhea
27
Q

What is Orlistat contraindicated for?

A
  • Pregnancy
  • Malabsorption syndrome
  • Cholestasis
  • Nephropathy
28
Q

How much weight loss does Orlistat typically yield?

A

2.6 kg

29
Q

List two pearls about Orlistat.

A
  • Take within 1 hour of each meal and skip dose if skipping a meal/meal does not contain fat
  • Decreases absorption of fat-soluble vitamins and contraceptives
30
Q

What sympathomimetics can be used for weight loss?

A
  • Phendimetrazine (Bontril)
  • Diethylpropion (Tenuate)
  • Phentermine (Adipex-P, Lomaira)
31
Q

What are sympathomimetics’ mechanism of action?

A

Release NE to decrease appetite and enhance satiety

32
Q

What adverse drug reactions are associated with sympathomimetics?

A
  • HTN
  • Palpitations
  • Arrhythmias
  • Insomnia
33
Q

What are sympathomimetics contraindicated for?

A
  • Within 14 days of MAO-I
  • Drug abuse history
  • Cardiovascular disease
  • Glaucoma
  • Hyperthyroidism
  • Pregnancy
  • Nursing/lactation
34
Q

List two clinical pearls for sympathomimetics.

A
  • Increase the effect of anti-diabetics
  • Monitor waist and weight every month for 3 months
35
Q
A

Fall 2020: Therapeutics 2 (11 decks)

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