NUTRITION

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PartA

Plantsterols are molecules that are similar to cholesterols in structureand are highly concentrated in vegetable oils and whole grains. Theyenable the body to reduce the intake of cholesterol through obscuringthe assimilation of cholesterol from food in the digestion tracthence excreted as waste [ CITATION EAT06 l 1033 ].They are not water soluble and require to be dissolved in somethingso as to enhance intestinal absorption. Plant sterols are plantcholesterol and are divided into sterols and stanols. Stanols aresubgroups of sterols that are saturated.

PartB

AdultTreatment Panel III guidelines were set in 2002 and updated in 2004by the National Heart, Lung, and Blood Institute (NHLBI). They focusmore on treating the cholesterol menace through regulation of LDLcholesterol levels. Highlights on the treatment of triglycerides arestipulated as well as lifestyle changes. Patients are grouped inaccordance with their risk factors after evaluation of the patient’scoronary heart disease risk factor[ CITATION USP14 l 1033 ].

The2013 American College of Cardiology critiqued this approach andsuggested that the treatment should assess and treat in accordancewith the cardiovascular risk level. It introduced the inclusion ofhigh-intensity statin. Though this new regulation was consideredslightly complicated than the “treat-to-target” approach, thephysician’s clinical judgment was highly emphasized in itsadministration. It targets the patients with high risk ofcardiovascular disease due to atherosclerosis or simply ASCVD. Justlike ATP III guidelines, it emphasizes on changing lifestyle andclassifies the patients into four categories namely those who havecardiovascular disease and those with LDL of 190 mg/dL or higher.Those with Diabetes Type 2 who are aged between 40 to 75 years andthose with risk of cardiovascular diseases in a span of 10 years butare between 40 to 75 years with a risk of 7.5% or greater[ CITATION USD02 l 1033 ].

PartC

Zocoris a prescription drug that is manufactured by Merck and Co and canbe used to treat cardiovascular conditions, high levels oftriglycerides and high cholesterols in the body. It is grouped asHMG-CoA reductase inhibitor as it inhibits the manufacture andproduction of cholesterol in the body through blocking of enzymesused in the production process[ CITATION Lar13 l 1033 ].Thedrug has statins that induce the liver to reduce and get rid of LDLcholesterol and triglycerides while increasing the production of HDL.It prevents diseases such as stroke, heart attack, and otherheart-related diseases are controlled. One of its side effects ismuscle pains as a result of skeleton muscle tissue breakdown thatcould lead to kidney failure.

SinceMr. Jones is 50 years old and has a high 10 year and lifetime risk ofASCVD, Zocor is a recommendable drug as long as a physician wellprescribes it[ CITATION Mer05 l 1033 ].

PartD:

Mr.Jones has an estimated 10 year and lifetime risk of obtaining ASCVDand Zocor and plant sterols are highly required for his body. MinuteMaid orange juice is proven to have CoroWise ™ plant sterols thatare effective in the reduction of blood and LDL cholesterol [ CITATION Sri06 l 1033 ].Taking two servings of Minute Maid orange juice daily with a mealwould actually assist in Mr. Jones’ cholesterol level though as perthe prescription, he requires 20 mg of Zocor (plant sterol).Substituting with a cup of 59 fl. –oz of Minute Maid orange juicedaily would offer approximately 1 mg per serving he takes. Inaccordance with the prescription, taking half dosage of Zocor (10 mg)with 1 mg of orange juice would not satisfy the level of plantsterols he requires in his body considering he is at an elevatedserum cholesterol level of 260mg/dL.

References

Long, L. (2013, May 01). Plant Sterols for Cholesterol Reduction. Retrieved from Whole Health Insider: http://www.wholehealthinsider.com/up-for-debate/up-for-debate-plant-sterols-for-cholesterol-reduction/

Merck Sharp &amp Dohme Limited. (2005). Zocor (Simvastatin) Tablets. In M. S. Limited, Prescribing Information for Zocor (pp. 1-22). USA: Merck Sharp &amp Dohme Corp.

Sridevi Devaraj, B. C. (2006). Reduced-Calorie Orange Juice Beverage with Plant Sterols Lowers C-reactive Protein Concentrations and Improves the Lipid Profile in Human Volunteers. The American Journal of Clinical Nutrition, 756-761.

Trautwein, E. (2006). Intake Occasion Affects the Serum Cholesterol Lowering of a Plant Sterol-enriched Single-dose Yoghurt Drink in Mildly Hypercholesterol Anaemic Subjects. European Journal of Clinical Nutrition, 325-333.

U.S. Department of Health and Human Services. (2002). Final Report: Cholesterol Guidelines. Retrieved from National Heart, Lung, and Blood http://www.nhlbi.nih.gov/health-pro/guidelines/current/cholesterol-guidelines/final-report

US Pharm. (2014). New Cholesterol Treatment Guideline: Implications for Pharmacy Practice. Retrieved from U.S. Pharmacist: r.search.yahoo.com/_ylt=A0LEVr_q_uRUL6MALJkPxQt._ylu=X3oDMTEzanJvMTU5BHNlYwNzcgRwb3MDNQRjb2xvA2JmMQR2dGlkA1lIUzAwNF8x/RV=2/RE=1424322411/RO=10/RU=http%3a%2f%2fwww.uspharmacist.com%2fcontent%2fc%2f48996%2f/RK=0/RS=ddrIRdg8mPa8BAKIZapHhxH9EgQ-

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