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Pharm Test 2 > 14 hypercholesterol& Dyslipidemia > Flashcards

14 hypercholesterol& Dyslipidemia Flashcards

1
Q

Many clinical trials demonstrate that increase of LDL levels induce formation of what?

A

Atherosclerosis plaques

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2
Q

What are the lipid lowering drugs?

A

Statins

Nicotinic Acid (Niacin)

Resins

Fibric Acid derivatives

Inhibitors of cholesterol absorption

PCSK9 Inhibitors

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3
Q

What are the 6 statins that are FDA approved?

A

Lovastatin

Simvastatin

Pravastatin

Atorvastatin

Rosuvastatin

Fuvastatin

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4
Q

Effects on LDL-C, HDL-C, triglycerides are dose related, meaning?

A

Dose should be set to achieve target LDL-C levels

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5
Q

What is Statin MOA?

A

Competitive inhibitors of HMG-CoA reductase

  • > prevents mevalonte synthesis
  • > dec in endogenous cholesterol synthesis by liver
  • > up regulation of LDL receptors in liver
  • > reduction in blood LDL levels
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6
Q

What is HMG-CoA?

A

Precursor for cholesterol synthesis

Integral ptn. of ER membranes

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7
Q

What is the major adverse effect of statin?

A

Myopathies

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8
Q

What is myopathy?

A

Intense myalgia

Serum creatinine levels elevated 10x

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9
Q

When taking a Statin, what drugs greatly increase myopathic symptoms?

A

Use with other lipid lowering drugs (fibrates)
= Gemfibrozil

drugs that inhibit P450 isoenzymes

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10
Q

Avoid administering statins with what drugs?

A

Fibrates

Antibiotics

Antifungals

HIV protease inhibitors

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11
Q

What are statin contraindications?

A

Active liver disease

Grapefruit juice

Pregnancy

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12
Q

What happens when a statin is taken with oral contraceptives, such as estrogens? What about progestins?

A

Estrogens:
Inc HDL
Dec LDL

Progestins:
opposite

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13
Q

What statin can be given to children 8 and older? 11 and older?

A

8: prova
11: atora, lova

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14
Q

What does Niacin refer to?

A

Nicotinic acid
&
Nicotinamide (B3)

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15
Q

What does a deficiency in vit B3 cause?

A

(along with def in tryptophan)

pellagra

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16
Q

What is considered the best agent to increase HDL levels?

A

Nicotinic acid

= Niacin

17
Q

What does Nicotinic acid do?

A

Inc HDL
Dec triglyceride
Dec LDL

18
Q

What are adverse effects of Niacin (nicotinic acid)?

A

Dyspesia accentuated by coffee, tea, alcohol

Flushing
Pruritus

19
Q

What drug should you limit for pt with diabetes? Why?

A

Niacin

Inc uric acid = gout

20
Q

What are bile-acid sequestrates?

A

Resins

21
Q

What is the safest lipid lowering agents?

A

Resins

22
Q

What is Bile-acid sequestrates (resins) MOA?

A

High (+) charged resins bind (-) charged bile acids

Resins are not absorbed & arrest bile acids

deplete cholesterol content
up regulate LDL
Inc triglyceride

23
Q

What are the 3 bile acid resins drugs?

A

Cholestyramine

Colestipol

Colesevelam

24
Q

What are resins drug interactions?

A

Interfere with absorption of Statins

Give statins 1 hr prior or 3-4 hr after

25
Q

What is fibric acid derivatives MOA?

A

Bind to PPAR activated receptors & stimulate beta oxidation of fatty acids

26
Q

What is the best way to decrease triglyceride levels?

A

Fibric Acid Derivatives

27
Q

What drug is given to pt with severe hypertriglyceridemia?

A

Genfibrozil

28
Q

What drug is given to pt with high triglycerides & high cholesterol?

A

Fenofibrate

29
Q

What are beneficial effects do fibric acids have independent of lipid lowering activity?

A

Antithrombotic

Immunomodluation

Antiinflammatory

30
Q

What drug does inhibition of dietary cholesterol uptake?

A

Ezetimibe

31
Q

What is Ezetimibe MOA?

A

Blocks NPC1L1, which facilitates cholesterol absorption

32
Q

What drug is used to prevent the compensatory increase in endogenous cholesterol synthesis when taking Ezetimbe?

A

Statins

33
Q

What should not be combined with Ezetimibe? Why?

A

Bile Acid Sequestrants

They inhibit absorption

34
Q

What are side effects of Ezetimibe?

A

Myopathy

Rhabdomyolysis

Myalgia

Hepatitis

Eczema

Fatigue

Headache

35
Q

What is PCSK9 inhibitors MOA?

A

dec LDL receptor degradation
inc recirculation of the receptor to the hepatocytes

-> lowers LDL in blood

36
Q

What drug do PCSK9 inhibitors work with?

A

Statins that inc LDL receptor expression

Pharm Test 2 (8 decks)

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