12. Lipid modifying Drugs

Question 1

Assessing the risk of CVD?

Answer 1

Use QRISK2 risk assessment tool to assess CVD risk for primary prevention

Question 2

When do you not use QRISK2?

Answer 2

Pre-existing CVD
Type 1 Diabetes Mellitus
Estimated golumerular filtrate
Famililal hypocholesterolaemia

Question 3

When will QRISK2 underestimate?

Answer 3

HIV 
Drugs 
Systemic lupus erythematosus
People taking hypertensive or lipid lowering drugs 
Severe obesity

Question 4

What if total cholesterol >7.5 mmol/L and family history of CVD

Answer 4

Familial hypercholsterolaemia should be considered

Question 5

What is triglycerides> 20mmol/L

Answer 5

Possible dietary indiscretion, alcohol excess and uncontrolled diabetes

Question 6

If triglycerides 4.5-9.9 mmol/L

Answer 6

CVD may be underestimated

Question 7

Statins mechanism action?

Answer 7

X

Question 8

What is the follow up advice for patients on statins?

Answer 8

Measure lipid profile again at 3 months
Aim for 40% or more reduction in non-HDL-cholesterol
If < 40% reduction check lifestyle, adherence to medication and consider increasing dose
Ask about adverse events and measure creatine kinase if c/o muscle pain
Check LFTs @ baseline 3 months and 12 months

Question 9

Ezetimibe mechanism of actions

Answer 9

Xx

Question 10

What are the side effects of ezetimbe?

Answer 10

Fatigue
GI disturbance
Headache
Myalgia

Question 11

What is alirocumab used for?

Answer 11

Primary hypercholesterolaemia or mixed dyslipidaemia

Question 12

Adverse reactions of alirocumab

Answer 12

Local injection site reactions
Upper resp tract infections
Pruritus

Question 13

What is evolocumab used for?

Answer 13

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