2-3. Dyslipidemia Drugs Flashcards
first line therapy for high cholesterol or TGs?
Diet
what class of dyslipidemia drugs are metabolized by CYP450?
Statins
3 contraindications for statins?
Pregnancy
Nursing mothers
Liver disease
MOA of ezetimibe?
inhibits cholesterol absorption in GI
function of Lipoprotein lipase? locaiton?
degrades TGs, chylomicrons and VLDL.
on vascular endothelial surface
3 MOA of fibrates?
receptor?
inc LPL (by inhibiting ApoC-III) inc HDL Dec TG (increase VLDL clearance)
Binds PPAR
effect of thiazides on lipid levels?
beta-blockers?
oral contraceptives
elevate cholesterol and TGs
elevates TGs and decrease HDL
elevate TGs
what dyslipidemia drug class are teratogenic?
Statins
3 MOA of statins?
reversible competitive inhibition of HMG CoA reductase
Increase hepatic LDL receptors
increase HDL
wt is elevated in Type III familial dysbetalipoproteinemia?
cause?
Chylomicrons and VLDL
defective ApoE
2 drug classes to lower TGs?
Fibrates
Niacin
wt is elevated in Type I familial hyperchylomicronemia?
2 cause?
tx?
chylomicrons, TG and cholesterol
deficient LPL or apolipoprotein C-II
diet. fibrates + nicotinic acid
hw to calculate LDL?
obtaine Total cholesterol
TG
HDL
wt is elevated in Type IV familial hypertriglyceridemia?
cause?
tx?
VLDL and TG
overproduction of VLDL
Fibrates
MOA of alirocumab and evolocumab?
PCSK9 inhibitors. PCSK9 degrades hepatic LDL receptors
2 statins that lower cholesterol and triglycerides?
2 ways they are different from other statins?
Atorvastatin
Rosuvastatin
longer t1/2
higher increase in LDL receptor
wt is elevated in Type IIa familial hypercholesterolemia?
IIb hyperlipoproteinemia?
cause?
IIa = LDL, cholesterol IIb = LDL, cholesterol and VLDL
defective/absent LDL receptors
main source for plasma lipids in the fasting state?
liver
wt lipids are most important for CV disease?
wt predisposes pts to acute pancreatitis?
cholesterol
TGs
severe hyperTGs = pancreatitis
2 lifestyle causes of high TGs?
high carbs and alcohol
2 AEs of fibrates?
Gall stones
myopathy
function of APo-B-100? 3 locations?
binds LDL receptor
LDL, HDL, IDL
2 dyslipidemia drugs that cause myopathy?
statins
Fibrates
2 AEs of statins?
Elevate LFTs
inc. CPK
wt esterfies cholesterol in periphery for packaging?
wt activates it?
location of activator?
LCAT
A-I
on HDL
hw to tx familial hypercholesterolaemia in adolescence?
Statins
main dietary determinants of plasma cholesterol?
why?
saturated and trans-unsaturated fatty acides
reduce LDL-receptor activity
why are statins associated with myalgia?
they increase CPK
first step when evaluating for lipid abnormalities?
consider the effect of other diseases and drugs
2 AEs of resins?
GI
dec absorption of ADEK vitamins and drugs
3 MOA of resins?
name some
bind bile acids in SI and inhibit reabsorption
Inc. hepatic LDL receptors
Inc. hepatic conversion of cholesterol to Bile acids
CHOLEStyramine, COLESevelam, COLEStipol
