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An epileptic patient who was stabilized on carbamazepine (800 mg/day) became severely depressed and was prescribed fluoxetine (SSRI) to treat the patient’s depressive disorder. After two weeks, neurotoxicity became apparent that was more suggestive of serotonin syndrome than of carbamazepine toxicity. A measurement of serum levels of fluoxetine showed 4 times the typical serum concentration.  Carbamazepine is a known inducer of CYP3A4.  Fluoxetine is chiefly metabolized by CYP2D6. The physician is considering switching antiseizure medications but it took considerable trial and error with multiple drugs to get the patient’s seizures under control.  Which of the following has the greatest likelihood of causing the elevated fluoxetine levels?   

True or false: John Cleese studies creativity in school.

Which of the following processes in xenobiotic metabolism is sometimes called “Phase 3” and involves transport proteins that are specific for polar metabolites?

What is the source of oxygen in the aldehyde dehydrogenase reaction?

What metabolite of ethanol builds up to toxic concentrations in persons who are homozygous for the ALDH2*2 allele?

Products marketed as “oxygen enhancers” aim to target which 5 variables? Please list all 5.

TRUE or FALSE: Athletes can develop a tolerance to caffeine and may see more benefit of caffeine use if they do a 7-10 day washout period preceding competition where no caffeine is consumed

You are working with an athlete who is a cross country long distance runner. It is calculated that they are consuming approximately 2975 calories per day and 365 grams of carbohydrate per day. Answer the following: 1. Calculate what percentage of their diet is coming from carbohydrate?  2. Does this fall into the recommended intake range for daily, general carbohydrate intake (aka NOT carbohydrate loading ranges)?  3. If this athlete begins to complain of early fatigue and poor recovery, what recommendation would you make to their daily carbohydrate intake level? 

1. What amount of potassium per day is considered excess? 2. If excess potassium is being consumed on a regular basis what negative side effects and health risks can occur?       

What percentage of calories should come from carbohydrates on a day-to-day basis for athletes looking to maintain and maximize glycogen storage?