Term
| What are the mechanisms by which statin meds work? (4) |
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Definition
| 1 Inhibits HMG-Co Reductase 2. Increases hepatic LDL receptors so more LDL is removed from the body via bile. 3. Increases LDL catabolism and decreased upregulation of VLDL to LDL. 4. Mild effect of raising HDL. |
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Term
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Definition
| It converts fatty compounds to precursors of sterols/cholesterol. |
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Term
| What are the adverse effects of statin meds? (6) |
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Definition
| Statin Myopathy, elevated liver enzymes, Nausia/diarrhea/constipation/muscle ache. |
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Term
| What do fibric acid derivatives do? |
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Definition
| They decrease the level of triglycerides in the blood. |
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Term
| How do fibric acid derivatives decrease the level of blood triglycerides? |
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Definition
| 1. Facilitates the clearance of triglyceride-enriched lipoproteins by stimulating lipoprotein lipase activity. 2. Reduces hepatic secretion of VLDL. 3. Raise level of HDL. |
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Term
| What effect do fibric acid derivatives have on LDL? |
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Definition
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Term
| What are some examples of fibric acid derivatives? (3) |
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Definition
| 1. Lopid 2. Tricor 3. Clofibrate. |
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Term
| What are the adverse side effects of fibric acid derivatives? |
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Definition
| 1. Stomach discomfort 2. Skin Rash 3. Abnormal liver enzyme tests 4. Muscle pains 5. Makes bile thicker and increases the risk of gall bladder problems. |
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Term
| How well do fibric acid derivatives work? (How much do they lower HDL and triglycerides?) |
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Definition
| HDL reduction of 20% and triglyceride reduction of 40-50%. |
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Term
| How do bile acid sequestrants decrease the risk of atherosclerosis? |
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Definition
| They bind to bile acids and prevent them from being re-absorbed into the blood, so the body produces more bile to replace what has been lost to the system. Since the body needs cholesetrol to make bile, the liver uses up the cholesterol in the blood to replace lowered bile levels, thus reducing the amt of LDL cholesterol in the blood. |
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Term
| What are some examples of bile acid sequestrants? |
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Definition
| Questran, Welchol, Locholest, Prevalite, Colestid (Cholestyramine, Colestipot, Colesevalam) |
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Term
| What are the adverse effects of bile sequestrants? (6) |
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Definition
| Constipation, bloating, fullness, nausia, gas. Decreaes absorption of some drugs. |
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Term
| What drugs do bile sequestrants inhibit absorption of? (4) |
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Definition
| warfarin, phenobarbital, NSAIDs, hydrocortisone by inhibiting absorption in the intestine. |
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Term
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Definition
| An amino acid that is needed to produce a chemical critical in detoxification pathways and ATP. |
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Term
| What is homocystine's mechanism of action? |
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Definition
| It enters the bloodstream and begins attacking blood vessels, which is the foundation of heart disease. |
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Term
| How does homocystine increase atherosclerotic risk? (3) |
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Definition
| 1. Prothrombotic and atherogenic properties 2. Oxidative damage of endothelial cells 3. Intimal thickening, elastic lamina disruption, smooth muscle hypertrophy, plately accumulation and formation of platelet-enriched occlusive thrombi. |
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Term
| How can homocystine be decreased? What is the mechanism of action? |
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Definition
| Nutritional supplements: combo of vitamin B-6, B-12 and folic acit - they convert homocystine to non-toxic substances. |
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Term
| What is metabolic syndrome? |
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Definition
| It's a metabolic syndrome charactarized by a constellation of metabolic risk factors. |
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Term
| What are the Sx of metabolic syndrome? (6) |
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Definition
| Elevated waist circumference, Elevated triglycerides, Decr. HDL, Incr BP, Incr fasting glucose |
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Term
| What is the prevalence of metabolic syndrome in the us? |
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Definition
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Term
| Describe saturated fat. (3 characteristics) |
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Definition
| Saturated w/ hydrogen; no room for additional [H]. Does not combine easily w/ O2. Solid @ room temp. |
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Term
| Why are saturated fats bad? |
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Definition
| Increases LDL levels and blood cholesterol levels. Contributes to atherosclerosis. |
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Term
| In what foods are saturated fats very common? (7) |
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Definition
| Coconut oil, milk, lard, meat, donuts, cookies, french fries. |
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Term
| Describe monounsaturated fats, their impact on cholesterol, and where they're found. |
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Definition
| Liquid @ room temp, one double bond. Decreases LDL w/o decr HDL. Found in olive, peanut and canola oils. |
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Term
| How do polyunsaturated fats impact bld cholesterol levels? (4) In what oils is it found? (3) |
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Definition
| polyunsaturateds decrease triglycerides, LDL, total cholesterol and HDL levels. Found in corn, sunflower and soybean oil. |
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Term
| Omega three is a unique polyunsaturated fat. What are the added benefits of this substance? |
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Definition
| They make blood platelets less likely to clot and increases their flexibility, thus decreases the risk of artery blockage. |
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Term
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Definition
| They are created by adding hydrogen ions to molecular bonds to turn liquid oils into solid fats. ie: margarine. |
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Term
| Why are trans fats used? How common are they? What kinds of foods are they in? |
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Definition
| Hydrogenation is done to increase food shelf life and flavor stability. Trans fats are found in 40% food products, ie: donuts, cookies, frenchfries and crackers. |
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Term
| What do trans fats do on the plasma level? |
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Definition
| Decreases HDL, Increases LDL, Increases risk of MI, stroke and diabetes. |
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Term
| What were the results of the nurse's health study? |
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Definition
| Women who consumed the greatest amts of trans fats had on average, a 50% higher risk of heart disease than women who had consumed the least. |
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Term
| How does smoking increase the risk of CAD? (8) |
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Definition
| 1. Platelet aggregation b/c makes blood cells more sticky. 2. Spasms & vasoconstriction in coronary arteries, decreasing flow to heart. 3. Triggers ventricular arrhythmias. 4. Lowers HDLs and allows LDLs to enter through the artery walls more easily, causing plaque buildup/atherosclerosis. 5. Reduces O2 carried by RBC. 6. Incr bld fibrinogen levels. 7. Incr BP 8. Incr LDL and trigylcerides. |
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Term
| Why is abdominal obesity considered especially problematic as a risk factor for CAD? |
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Definition
| It can increase risk of HTN, type 2 diabetes, dyslipidemia, CAD and premature death compared w/ pts w/ fat distributed around hips and thighs. |
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Term
| How is central obesity quantified? |
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Definition
| Use the waist circumference. males>40" and F>35" are at high risk of morbidity. |
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Term
| What are the detrimental effects caused by decreasing estrogen in postmenopausal women? |
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Definition
| 1. Incr LDL 2. Decr: vascular response, antioxidant effects of estrogen and regulation of proliferation in vasculature. |
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Term
| estrogen therapy used to be a primary preventative measure for CAD. Why isn't it anymore? |
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Definition
| B/c more recent studies have controlled for confounding factors and found that estrogen isn't as effective at achieving effects as previously thought. Additionally, there is a high risk of breast cancer w/ Tx. |
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Term
| Why would low socioeconomic level contribute to the risk of developing CAD? |
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Definition
| 1. high saturated fat diet 2. high cholesterol 3. increased prevalence of smoking 4. increaced BP 5. High BMI 6. Incr alcohol intake 7. sedentary lifestyle 8. less access to medical services. |
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Term
| How does exercise decrease the risk of atherosclerosis? (7) |
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Definition
| 1. Increases HDL 2. Decreases BP 3. Decreases obesity 4. Keeps bld vessels more flexible to decr dmg to walls 5. Decreases fibrinogen levels. 6. Promotes NO in vessel lining 7. Promotes angiogenesis, for incr bld flow to tissue. |
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Term
| How does HDL help decrease risk of atherosclerosis? |
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Definition
| Helps take excess cholesterol from bld to liver. |
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Term
| How does increased NO decrease risk of atherosclerosis? (3) |
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Definition
| Dilates vessels, inhibits clumping of platelets, reduces adhesion of platelets to the vessel wall. |
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Term
| What is the difference btw primary and secondary prevention? |
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Definition
| PRIMARAY: Interventions to prevent an acute cardiac event from ever occuring. SECONDARY: Interventions to prevent the occurance from worsening. |
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Term
| What is a form of primary prevention for each of the follwoing things: Incr HDL, Cigarette smoking, obesity and HTN. |
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Definition
| HDL: Healthy diet, low saturated fats. CIGARETTES: Never start smoking. OBESITY: Cardiovascular exercise. HTN: Limit sodium consumption. |
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Term
| What are some forms of secondary prevention for: High LDL, Cigarettes, Obesity and HTN. |
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Definition
| LDL: Statin meds CIGARETTES: cessation. OBESITY: decr caloric intake HTN: Diuretics/B Blockers |
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Term
| Why isn't primary prevention a priority in the US? (3) |
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Definition
| It requires a change in habits, and is considered more expensive because it takes a long time before you see the return on the money spent. There also isn't much corporate profit for public health initiatives like that. |
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Term
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Definition
| They are made by the liver and are the primary carriers of cholesterol in the blood to the organs and cells. They're the highest percentage of cholesterol in most people. |
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