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COMT inhibitors
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Catechol-O-methyl transferase [COMT] is the second major enzyme
involved in the breakdown of Levodopa in the periphery
These drugs slow the breakdown of Levodopa and so there is prolonged
effect, smoother blood levels and less response fluctuations
Used in those on 3 or more daily doses of Levodopa
Entacapone, Tolcapone
What are the types of lipoproteins?
Give this one a try later!
, Chylomicrons: largest type; elevated after fatty meals; high levels
associated with pancreatitis
VLDL: Measure of remnant particles [indirect measurement of IDL]
IDL: Very atherogenic when present
LDL: Primary target of lipid-lowering therapy; small dense
particles are atherogenic
HDL: Responsible for transport of cholesterol from tissues to liver for
removal; low levels associated with atherogenesis [HDL2 most protective]
Pharmacotherapy for obesity
Give this one a try later!
FDA approved meds may be part of comprehensive program including diet
& activity
Xenical Phentermine
Newer:
Qsymia (phentermine/topiramate)
BMI >/= 30 w/o concomitant obesity related RFs or diseases
BMI >/= 27 w/ RFs or diseases Requires continual monitoring
Ozempic is not FDA approved for weight loss
Physical Activity tips for Obesity
Give this one a try later!
, Accumulate up to 30 minutes per day (10
Step counters (pedometers) 2000 steps=1 mile
Newer guidelines say 60 minutes daily
Average = 2000 6000 = maintain wt 10,000 = to lose wt (5 miles)
Wt Training increases capacity to burn calories (more muscle mass & inc
BMR)
What are blood pressure goals (JNC 8)
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SBP <140 mm Hg (unless >60 years, then 150)
DBP < 90 mm Hg
Home SBP <135 mm Hg
Home DBP <85 mm Hg
For patients with diabetes, heart failure, or chronic renal failure
BP <140/90 mm Hg
If goal BP cannot be met, partial control yields some benefit
Goals in Older Adults <140/90: 65-79
140-145 for 80 + if tolerated
Serum Iron levels
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• Females: 65-165 ng • Males: 75-175 ng
, Diuretics for hypertension
Give this one a try later!
Most Common to treat HTN:
-Thiazides/ Thiazide-like diuretics: These are to given to patients with
Normal renal function, and are the Best initial choice for African Americans
due to their low renin thresholds.
-Loop Diuretics: these promote renal blood flow (so good to use in
patients with renal problems), and good to use in African Americans due to
their low renin thresholds
-Combinations of Hydrochlorothiazide (a thiazide) with Potassium sparing
diuretics and other antihypertensive drugs (like ACE inhibitors), will help
normalize the potassium levels (most common will see a thiazide with an
ACE inhibitors)
Metabolic Syndrome
Give this one a try later!
Abdominal obesity
Men: waist circumference > 102 cm / 40 in. Women: waist circumference >88
cm / 35 in.
Atherogenic dyslipidemia (triad)
High triglycerides (> 150 mg/dL), Small LDL particles so LDL-C is low or
mildly elevated, Low HDL (< 40 men; <50 women)
Elevated blood pressure (>/= 130/85)
Insulin resistance (impaired fasting glucose >/= 100)
Prothrombotic and pro-inflammatory states (not usually measured but
implied with + metabolic syndrome)
COMT inhibitors
Give this one a try later!
Catechol-O-methyl transferase [COMT] is the second major enzyme
involved in the breakdown of Levodopa in the periphery
These drugs slow the breakdown of Levodopa and so there is prolonged
effect, smoother blood levels and less response fluctuations
Used in those on 3 or more daily doses of Levodopa
Entacapone, Tolcapone
What are the types of lipoproteins?
Give this one a try later!
, Chylomicrons: largest type; elevated after fatty meals; high levels
associated with pancreatitis
VLDL: Measure of remnant particles [indirect measurement of IDL]
IDL: Very atherogenic when present
LDL: Primary target of lipid-lowering therapy; small dense
particles are atherogenic
HDL: Responsible for transport of cholesterol from tissues to liver for
removal; low levels associated with atherogenesis [HDL2 most protective]
Pharmacotherapy for obesity
Give this one a try later!
FDA approved meds may be part of comprehensive program including diet
& activity
Xenical Phentermine
Newer:
Qsymia (phentermine/topiramate)
BMI >/= 30 w/o concomitant obesity related RFs or diseases
BMI >/= 27 w/ RFs or diseases Requires continual monitoring
Ozempic is not FDA approved for weight loss
Physical Activity tips for Obesity
Give this one a try later!
, Accumulate up to 30 minutes per day (10
Step counters (pedometers) 2000 steps=1 mile
Newer guidelines say 60 minutes daily
Average = 2000 6000 = maintain wt 10,000 = to lose wt (5 miles)
Wt Training increases capacity to burn calories (more muscle mass & inc
BMR)
What are blood pressure goals (JNC 8)
Give this one a try later!
SBP <140 mm Hg (unless >60 years, then 150)
DBP < 90 mm Hg
Home SBP <135 mm Hg
Home DBP <85 mm Hg
For patients with diabetes, heart failure, or chronic renal failure
BP <140/90 mm Hg
If goal BP cannot be met, partial control yields some benefit
Goals in Older Adults <140/90: 65-79
140-145 for 80 + if tolerated
Serum Iron levels
Give this one a try later!
• Females: 65-165 ng • Males: 75-175 ng
, Diuretics for hypertension
Give this one a try later!
Most Common to treat HTN:
-Thiazides/ Thiazide-like diuretics: These are to given to patients with
Normal renal function, and are the Best initial choice for African Americans
due to their low renin thresholds.
-Loop Diuretics: these promote renal blood flow (so good to use in
patients with renal problems), and good to use in African Americans due to
their low renin thresholds
-Combinations of Hydrochlorothiazide (a thiazide) with Potassium sparing
diuretics and other antihypertensive drugs (like ACE inhibitors), will help
normalize the potassium levels (most common will see a thiazide with an
ACE inhibitors)
Metabolic Syndrome
Give this one a try later!
Abdominal obesity
Men: waist circumference > 102 cm / 40 in. Women: waist circumference >88
cm / 35 in.
Atherogenic dyslipidemia (triad)
High triglycerides (> 150 mg/dL), Small LDL particles so LDL-C is low or
mildly elevated, Low HDL (< 40 men; <50 women)
Elevated blood pressure (>/= 130/85)
Insulin resistance (impaired fasting glucose >/= 100)
Prothrombotic and pro-inflammatory states (not usually measured but
implied with + metabolic syndrome)
