NMT 150 final quiz

Hypertension Management

• Non-pharmacological interventions for prevention of hypertension:
  • Weight loss
  • Healthy diet (DASH diet)
  • Reduced intake of dietary sodium
  • Increased potassium intake
  • Aerobic and resistance exercises
  • Moderation in alcohol consumption
• Impact on blood pressure: -5 mmHg (weight loss) -11 mmHg (DASH diet) -5 to -6 mmHg (reduced sodium intake) -4 mmHg (increased potassium intake) -4 mmHg (aerobic exercise) -~5.5 mmHg (moderation in alcohol consumption)

Etiologies of Erectile Dysfunction

• Vascular: CVD, hypertension, DM, smoking, major surgery, radiotherapy, hyperlipidemia
• Neurologic: spinal and brain injuries, Parkinson disease, Alzheimer disease, multiple sclerosis, stroke, major surgery, radiography of prostate
• Local penile (cavernous) factors: Peyronie’s disease, cavernous fibrosis, penile fracture
• Hormonal: hypogonadism, hyperprolactinemia, hyper/hypothyroidism, hyper/hypercortisolism
• Drug-induced: anti-hypertensives, antidepressants, antipsychotics, recreational drugs, alcohol
• Psychogenic: performance anxiety, PTSD, relationship issues, anxiety, depression, stress

Low Back Pain Treatment

• IFC (Interferential Current): treatment involves electrical current, used to relieve pain and relax muscle
• TENS (Transcutaneous Electrical Nerve Stimulation): works with pain gate control theory and endorphin release
• Ultrasound: sound waves go 2-5cm into soft tissue, good for tissues with high collagen content (tendons, ligaments, joint capsules, fascia, connective tissue)

Adaptogens and Anti-Inflammatory Diet

• Adaptogens:
  • Stimulating: Panax ginseng (Korean red ginseng), Rhodiola rosea
  • Immune adaptogens: Astragalus, Panax quinquefolius (North American ginseng)
  • Hypotensive: Withania somnifera (Ashwagandha), Rehmania
• Anti-inflammatory diet:
  • Focus on fruits, vegetables, nuts, legumes, whole grains, and unsaturated fats
  • Low glycemic index/load diet
  • Omega 3-rich foods and polyphenol-rich fruits and vegetables
  • Limited intake of animal products and pro-inflammatory foods

Opioids in Pharmacology

• Full opioid agonists: morphine, codeine
• Partial opioid agonists: tramadol
• Opioid antagonists: naloxone
• Side effects: analgesia, respiratory depression, euphoria, sedation, hypotension, vasodilation, constipation, N/V

Traditional Chinese Medicine

• Heart: governs blood, controls sweat, and manifests in complexion, opens into the tongue, houses the mind (shen), and is associated with the fire element
• Small intestine: separates pure from turbid, communicates with stomach, spleen, bladder, and large intestine
• Pericardium: protects the heart, governs blood, and houses the shen
• Triple warmer: mobilizes original Qi, controls transportation and penetration of Qi, and controls water passages and excretion of fluids

IBS/GI Botanical Medicine

• Botanicals for IBS:
  • Peppermint: carminative, anti-emetic, antispasmodic
  • Lemon balm: carminative, antispasmodic
  • Fennel: carminative, antispasmodic
  • Curcumin: anti-inflammatory
  • Psyllium: bulk laxative, demulcent
  • Flaxseed: bulk laxative, demulcent, phytoestrogen

Homeopathy and Naturopathic Approach to IBS

• Remove food sensitivities, add fiber, relieve flatulence, eliminate cramping, stimulate laxatives, and manage stress### Point Classifications
• 5 transporting points: Well-Spring-Stream-River-Sea
• Source points: 12 regular meridians
• Influential points: Qi, blood, zang, fu, bone, marrow, sinews, vessels
• Command points: face/mouth, posterior neck, abdomen, back
• Back shu: 12 primary meridians, mainly for physical concerns and less emotional/spiritual
• Outer back shu: more emotional/spiritual, next to back shu points
• Front mu: 12 primary meridians, for both physical + emotional concerns

Botanical Medicine for Hypertension and CVD

• Lily of the valley (Convallaria): hypertension, CHF, any cardiovascular conditions; contains cardiac glycosides; use with caution; avoid in pregnancy
• Hawthorn (Crataegus oxyacantha): cardiotonic, hypotensive, vascular tonic, nutritive; use in hypertension or CVD/CHF; flavonoids; safe
• Linden (tilia cordata): cardiotonic, circulatory tonic, nervine, hypotensive; use in anxiety, CVD related to stress/anxiety, hypertension, URTIs; volatile oils, flavonoids, mucilage, tannins; safe
• Garlic (allium sativum): vascular tonic, antimicrobial, hypotensive, stink-producer; use in digestive infections, skin infections, URTI, CVD, hypertension; safe
• Cayenne (capsicum frutescens): stimulant, circulatory tonic, rubefacient; use in circulatory deficiencies, arthritis, pain relief; safe
• Hibiscus: ePective hypotensive + vascular tonic; use in hypertension, inflammation, and heat patterns; flavonoids, vitamin C, tannins, anthocyanidins; mild uterine tonic

Homeopathy Questions

• Number needed to treat (NNT) to benefit 1 person: measure of how many people need to be treated for 1 person to have a benefit
• Number needed to harm (NNH): measure of how many people need to be treated for 1 person to have an adverse effect
• Antihypertensive therapy: MI ARR = 0.7%, NNT = 143, 20-40% risk reduction for first major cardiovascular event vs. placebo
• Statin therapy: cardiovascular event ARR = 1.39%, NNT = 52, most common adverse effect is myalgia
• Low-dose ASA: major cardiovascular event ARR = 0.4%, NNT = 241, major bleeding usually within GI tract

Drugs that Lower Cholesterol

• HMG CoA Reductase inhibitors (statins): lower LDL-C, prevent CVD, stabilize plaques; can cause rhabdomyolysis
• Absorption Inhibition: Ezetimibe; cannot absorb cholesterol into the lumen (bile acid binding resins)
• Cholestyramine: bile acid binding, allows more LDL-C to be used up
• Fibrates: not as good for LDL-C, better for increasing HDL and decreasing cholesterol (reducing triglycerides); benefit best in diabetic populations; can cause rhabdomyolysis
• Niacin: broadest spectrum but needs to be a huge dose, which causes intense flushing/itching; works by inhibiting lipolysis in adipose tissue; reduces formation and secretion of VLDL (precursor to LDL)

Root Cause and Treatment

• Expels wind: specifically for wind, opens gates to allow wind to escape (wind gate, posterior neck); exterior wind caught in Wei Qi layer
• Calms the mind: slows overactive mind or quickens slow mind; helps with insomnia from overactive mind; treats depression, anxiety, stress
• Removes obstruction: obstructions usually manifest as pain or lack of flow; can be used for stagnation (gi, blood, phlegm/damp, cold); symptom treatment vs. cause

Erectile Dysfunction and Weight

• Key treatment principles: differentiate between physical and mental/emotional causes; differentiate between difficulty with arousal vs. Follow same procedure for guan and chi pulses
• Normal variations in pulses: athletes, women, children, heavier set, thin, fasting individuals
• Pulse variables: speed, type, depth, intensity
• Treatment plans: written as Zang-Fu diagnosis, multiple organs can be included, objective is to treat the underlying dysfunctionHere are the study notes for the provided text:

Non-Specific Low Back Pain (NSLBP)

• Definition: pain and stiffness in the lower back region
• Physical Medicine:
  • Interferential Current (IFC) therapy: relieves pain and muscle spasms, improves circulation
  • Transcutaneous Electrical Nerve Stimulation (TENS): temporary pain relief, 20-minute sessions
  • Ultrasound: treatment for tissues with high collagen content (tendons, ligaments, fascia)
  • Laser therapy: promotes wound healing, reduces inflammation and pain
• Homeopathy:
  • Sepia: treatment for NSLBP with depression, symptoms worsen with activity, cold, and sadness
  • Natrum: treatment for NSLBP with grief, depression, and emotional vulnerability
  • Rhus tox: treatment for NSLBP with stiffness, redness, and swelling
• Botanical Medicine:
  • Adaptogens: help body adapt to stress and promote healing (Panax ginseng, Rhodiola rosea, Astragalus)
  • Anti-inflammatory diet: emphasizes fruits, vegetables, nuts, legumes, whole grains, and unsaturated fats

Pharmacology

• Opioids:
  • Indications: acute, severe low back pain
  • Contraindications: depression, anxiety, PTSD, substance abuse
  • Side effects: analgesia, respiratory depression, constipation, nausea, and vomiting
• Opioid classes:
  • Full agonists: morphine, codeine
  • Partial agonists: tramadol
  • Antagonists: naloxone

Traditional Chinese Medicine (TCM)

• Heart and Small Intestine Channel:
  • Heart functions: governs blood, controls sweat and complexion, houses the mind (Shen)
  • Small intestine functions: separates pure from turbid, communicates with heart, stomach, bladder, and large intestine
• Pericardium Channel:
  • Protects the heart, governs blood, houses the Shen
• Triple Warmer Channel:
  • Mobilizes Original Qi, controls transportation and penetration of Qi, controls water passages and excretion of fluids

Gastrointestinal (GI) Issues

• IBS:
  • Symptoms: abdominal pain, bloating, gas, changes in bowel habits
  • Naturopathic approach: remove food sensitivities, increase fiber, relieve flatulence, eliminate cramping
• Botanical Medicine for IBS:
  • Peppermint: carminative, anti-emetic, antispasmodic
  • Lemon Balm: carminative, anti-emetic, cramping
  • Fennel: indigestion, bloating, antispasmodic, anti-inflammatory
• Homeopathy for IBS:
  • Nux vomica: anxiety, constipation, bloating, headaches
  • Podophyllum peltanum: IBS-like symptoms, gallbladder pain, bloating, gas

Erectile Dysfunction (ED)

• Causes: vascular, neurologic, hormonal, local penile, and psychogenic factors
• Non-pharmacological interventions: weight loss, healthy diet, increased potassium intake, physical activity, moderation in alcohol intake