Anit-hyperlipidemic Drugs

Question 0

Niacin/ niaspan

Answer 0

B vitamin
Dec VLDL w/inc clearance
For elevated total cholesterol
May cause I ntense flushing and puritis

Question 1

Niacin/ nicotinic acid

Answer 1

B vitamin
Dec VLDL synthesis in liver, increasing VLDL clearance in plasma
For elevated total cholesterol- VLDL/LDL/TG with low HDL
Less flushing than niaspan
Monitor LFT’s with continued use

Question 2

Inositol hexaniacinate

Answer 2

Non- prescription supplement of niacin
Better tolerated
500-1000 mg 3x/d w/ meals

Question 3

Gemfibrozol/ Lopid

Answer 3

Fibrin acid derviative
Dec TG produced in liver
For elevated TG levels, low HDL, type IV & V hyperlipidemia
May cause liver damage, gallstone, nausea, diarrhea, GI upset, rhabdomyosis & myalgias

Question 4

Cholestyramine/ questran

Answer 4

Bile acid sequestrant
Forms insoluble complex with bile salts- results in greater amount of cholesterol oxidized into bile acids = inc excretion
For elevated cholesterol, LDL
May interfere with absorption of fat soluble vitamins, contipation, bloating
Take before/after other drugs- may bind to other drugs

Question 5

Atrovastatin/ Lipitor

Answer 5

Anti hyperlipidemic- HMG-CoA reductase inhibitor(statin)
Inhibits HMG-CoA reductase in liver- prevents cholesterol synthesis
For elevated total cholesterol, sympathetic & non-sympathetic CAD
may cause MUSCLE SORENESS, possible rhabdomyosis- check liver enzymes, CPK levels
CATEGORY X
10,20,40,80mg tabs- initially 20mg 1x/d, maximum 80mg 1x/d

Question 6

Ezetimibe/ Zetia

Answer 6

Cholesterol absorption inhibitor
Inhibits intestinal absorption of cholesterol at the brush border
For elevated cholesterol
May cause diarrhea, myalgias, arthralgias, abdominal pain
Often used in conjunction with a statin
category C