16. DSA Drugs used for Lipid Disorders

Question 1

All of the following are what type of drugs for lipid disorders?
Atorvastatin
Fluvastatin
Lovastatin
Pitavastatin
Pravastatin
Rosuvastatin
Simvastatin

Answer 1

HMG-CoA Reductase Inhibitors (statins)

Question 2

All of the following are what type of drugs for lipid disorders?
Known as nicotinic acid/vitamin B3

Answer 2

Niacin

Question 3

All of the following are what type of drugs for lipid disorders?
Fenofibrate
Gemfibrozil

Answer 3

Fibric Acid Derivatives (Fibrates)

Question 4

All of the following are what type of drugs for lipid disorders?
Cholestyramine
Cholesevelam
Colestipol

Answer 4

Bile Acid Sequestrants (Resins)

Question 5

All of the following are what type of drugs for lipid disorders?
Ezetimibe

Answer 5

Cholesterol Absorption Inhibitors

Question 6

All of the following are what type of drugs for lipid disorders?
Lomitapide
Mipomersen
Evolocumab
Alirocumab

Answer 6

New treatments

Question 7

The statins are most effective at reducing LDL and the best tolerated class of lipid lowering agents. What is the MOA?

Answer 7

they are structural analogs of HMG-CoA and inhibit HMGCoA reductase which is the rate limiting enzyme in cholesterol synthesis

Question 8

What it the potency of the statins?

Atorvastatin=rosubastatin> simvastatin > pitavastatin = lovastatin = pravastatin > ?

Answer 8

Fluvastatin

use in atherosclerotic valvular dz/ acute coronary syndromes

Question 9

Niacin decrease TGs, LDL, Lp(a) lipoproteinA and increases?

Answer 9

HDL

use for statin intolerant pts

Question 10

The MOA of niacin is it inhibits lipolysis of TGs in adipose tissue, by reducing free fatty acids- liver produces less VLDL and?

Answer 10

LDL levels decrease, catabolic rate for HDL decreased

Question 11

Gemfibrozil and Fenofibrate (fibric acid derivatives) are well absorbed. Which has a longer half life?

Answer 11

gemfibrozil has 1.5hrs

Fenofibrate is 20hrs

Question 12

Fibrates MOA : they are agonists for peroxisome proliferator activated receptor alpha (PPARa - nuclear receptor), activation binds to DNA regulating expression of APO binding proteins. Leads to VLDL decrease, LDL decrease, and HDL?

Answer 12

increases moderately 
(inc. lipolysis of TGs = decrease plasma TG)

use in low HDL or hyperTG

Question 13

Fibrates are useful in the management of hypertriglyeridemias where VLDL predominates, dystbetalipoproteinemia and hypertriglyceridemia that resutls from treatment with?

Answer 13

viral protease inhibitors

Question 14

Bile acid sequestrants (resins): cholestipol, cholestyramine, and colesevelam are cationic (negative) exchange resins which bind to positively charged compounds and cause an increase in the up take of?

Answer 14

bile acid excretion 10 fold

Question 15

Bile acid sequestrants are used to treat pts with primary hypercholesterolemia (*dec. LDL), also used to relieve pruritis in patients with bile salt?

Answer 15

accumulation (from obstruction)

Question 16

Cholesterol absorption inhibitors such as ezetimibe block sterol transporter NPC1L1 in intestine brush border, inhibiting reabsorption of cholesterol excreted in bile, decreases LDL and phytosterols.. Good for what clinical sitch?

Answer 16

Elevated LDL

Phytosterolemia (characterized by hyperabsorption and decreased biliary excretion of dietary sterols)

Question 17

What drugs are best to decrease LDLs?

Answer 17

Statins

Question 18

What drugs are best to increase HDL, and the worst?

Answer 18

Best HDL: Niacin

Worst HDL: Bile acid

Question 19

What drugs work best to decrease TGs and VLDL?

Answer 19

Fibrates (gemofibrozil and fenofibrate)

Question 20

PCSK9 inhibitors such as (evolocumab), complec with PCSK9 and inhibit catabolism of LDL receptor. Increasing LDL receptors, decreasing LDL, Best for what situation?

Answer 20

Familial hypercholesterolemia not responsive to oral therapy

Question 21

What is a common side effect of statins?

Answer 21

can cause myopathy - proximal muscle weakness and soreness (cant raise arms above head)

Question 22

Which statin is the only statin that is not metabolized in the liver by CYP450?

Answer 22

Pravastatin

Question 23

Cholestyramine, colestipol, colesevam (bile acid binding resins) causes hypertriglycemia (inc. VLDL) and can also cause constipation, bloating and?

Answer 23

gall stones

Question 24

Common side effects of ezetimibe (cholesterol absorption inhibitor) is diarrhea and an increase in?

Answer 24

Liver function tests

Question 25

Common side effects of fibrates is when they are combined with statins can lead to myopathy, fibrates on their own can lead to cholesterol…?

Answer 25

gall stones

Question 26

Common side effects of niacin is cutatneous flushing and warmth, hyperglycemia, hyperuricemia, as well as elevated…?

Answer 26

liver function tests