OTC > Wellness > Flashcards

Wellness Flashcards

(102 cards)

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1
Q

It is thought that more time at home leads to…

A

more screen time and less outdoor physical activity = obesity

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2
Q

Quarantine issues:

A
  • lack of sleep
  • altered eating habits
  • decreased physical activity
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3
Q

BMI utilizes a person’s…

A

height and weight

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4
Q

How to find BMI:

A

kg/m2 or (lbs/in2)x703

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5
Q

Overweight people have a BMI of…

A

25-29.9 kg/m2

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6
Q

Obese people have a BMI of…

A

30 or greater

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7
Q

Class 1 obesity has a BMI of…

A

30-34.9

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8
Q

Class 2 obesity has a BMI of…

A

35-39.9

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9
Q

Class 3 obesity has a BMI of…

A

over 40

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10
Q

BMI has limitation b/c of…

A

very muscular individuals

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11
Q

Instead of just relying on BMI, we can also consider…

A

measuring waist circumference

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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

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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
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14
Q

Associated chronic health problems:

A
  • cerebrovascular disease/stroke
  • hypertension
  • type 2 diabetes
  • osteoarthritis
  • sleep apnea
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15
Q

Obesity has the most effect on what health problem?

A

diabetes

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16
Q

Medications associated w/ weight gain:

A
  • 2nd generation antipsychotics
  • antidepressants
  • hormonal contraceptives
  • corticosteroids
  • anticonvulsants
  • insulin/sulfonylureas/thiazolidinediones
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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

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18
Q

What is the mainstay for weight loss therapy?

A

dietary modification or restriction

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19
Q

Exercise is less efficient _____, but important for ______

A

initially, maintenance and improving overall fitness

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20
Q

Reduced calorie diet and increased physical activity leads to…

A

greater weight loss and reduction of abdominal fat

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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

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22
Q

OTC orlistat 60mg can be used if…

A

BMI is over 25 kg/m2

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23
Q

MOA of orlistat:

A
  • reversible inhibitor of gastric and pancreatic lipases, which stops hydrolysis of TGs
  • inhibits 30% of dietary fat absorption
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24
Q

OTC dose of orlistat:

A

60 mg capsule

  • approved for ages > 18
  • take TID before meals that have fat
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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
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