Anti-Cholesterol

Question 1

Chylomicrons

Answer 1

largest. formed in the instestine and carry TG and CHOL of dietary origin to peripheral tissues.
hydrolyzed by LPL.
remnants then travel to the liver

Question 2

VLDL

Answer 2

secreted by liver. carries TG/chol made in the liver to peripheral tissues.
hydrolyzed by LPL and converted to IDL, then to LDL

Question 3

LDL

Answer 3

derived from VLDL remnants by LPL

carries CHOL to tissues with LDL receptor B-100.

Question 4

HDL

Answer 4

synthesized by liver and intestine.

reverse chol transport - from the periphery to the liver

Question 5

Primary dyslipidemia

Answer 5

result of a single gene defect or a combo of genetics and diet

Question 6

Secondary dyslipidemia

Answer 6

result of a general metabolic disorder: DM, alcohol intake, glucocorticoid excess, estrogen/OCP, hypothyroidsism, BB/THZ diuretics

Question 7

Tx of hypercholesterolemia

Answer 7

“statins”
niacin
bile acid sequesterants

Question 8

Tx of hypertriglyeridemia

Answer 8

Fibric acid derivatives

niacin

Question 9

Tx of low LDL

Answer 9

niacin
fibrates
HMG CoA reductase inhibitors

Question 10

HMG CoA reducatase inhibitor Drugs

Answer 10

“statins”
Simvastatin
Lovastatin
Pravastatin

Question 11

HMG CoA reductase inhibitor MOA

Answer 11

Inhibits the rate limiting step in cholesterol biosynthesis — decrease in chol = compensatory increase in LDL receptors — increase removal of LDL from plasma

Question 12

HMG CoA reductase inhibitors Adverse reactions

Answer 12

Administer in the evening
Pregnancy category X
sometimes myopathy

Question 13

Inhibitor of cholesterol absorption Drug

Answer 13

Ezetimibe

Question 14

Inhibitor of CHOL ABS MOA

Answer 14

inhibits intestinal abs of dietary and biliary cholesterol

Question 15

Bile Acid Sequesterant Drugs

Answer 15

Cholestyramine

Colestipol

Question 16

Bile Acid Sequesterant MOA

Answer 16

bind bile salts in the gut and increase excretion tenfold –> more cholesterol must be converted to bile acids -> LDL receptor upregulation and increased removal from plasma

Question 17

Bile Acid Sequesterant Adverse Effects

Answer 17

Contraindicated in patients with high triglycerides

Question 18

Fibric Acid Derivatives MOA

Answer 18

Increases activity of lipoprotein lipase –> increased VLDL clearance, increases production of HDL

Drug of choice for hypertriglyceridemia

Question 19

Niacin MOA

Answer 19

decreases VLDL secretion - inhibits release of free fatty acids from tissues (decreases availability of VLDL precursors)

largest pharmacologic effect to increase HDL levels

Question 20

Niacin Adverse Reactions

Answer 20

flushing and dyspepsia