Anti-Hyperlipidemics Flashcards
What is the function of NPN1L1?
allows cholesterol to enter the enterocyte
What enzyme esterifies cholesterol inside of the enterocyte?
ACAT
What is the function of Apolipoprotein C-II?
lipoprotein lipase cofactor
What is the function of Lipoprotein Lipase?
breaks down chylomicron to be used by tissues
What is the largest component of VLDLs?
triglycerides
What is the ratio of triglyceride to cholesterol esters in VLDL?
5:1
What is the ratio of triglyceride to cholesterol esters in IDL?
1:1
What is the function of ApoB 100?
LDL receptor ligand
What are the two fibrates?
Gemfibrozil and Fenofibrate
What are the three MOAs of fibrates?
large decrease VLDL
small decrease in LDL
small increase in IDL
What receptor do fibrates bind?
PPAR
increased expression of LDL
What two apolipoproteins does PPAR activate?
A-I and A-II
What are the three bile acid binding resins?
Cholestyramine, Colestipol, Colesevelam
What is the main adverse effect of bile acid binding resins?
increase triglyceride levels
What is the MOA of Niacin?
inhibits adipocyte hormone sensitive lipase
What two lipoproteins does niacin decrease the synthesis of?
VLDL and LDL
Which apolipoprotein can niacin activate?
A-I
What causes the flushing associated with Niacin?
release of prostacyclin
What drug can reduce the flushing associated with niacin?
NSAIDs
What metabolite do pt’s taking NIACIN run the risk of increasing?
uric acid
What statin can be safely used with niacin?
fluvostatin
Which statin shouldnt be used with niacin?
lovastatin
What drug inhibits cholesterol absorption?
ezetimibe
What is the MOA of ezetimibe? What does this lead to?
blocks NPC1 like protein on enterocytes?
decreased absorption of cholesterol
What is the magic number for statins?
10 yr cholesterol risk greater than 7.5%
What is the MOA of all statins?
HMG-CoA Reductase Inhibitors
What is the one potential adverse effect of statins?
Myopathy
What two enzymes can be increased in pt’s taking statins?
AST and ALT
What causes familial hyperchylomicronemia?
LPL defect
What causes familial hypertriglyceridemia?
impaired removal or VLDL or chylomicrons
What causes familial combined hyperlipoproteinemia?
increased VLDL production
What causes familial dysbetalipoproteinemia?
absence of ApoE
Accordig to Wauson, which two receptors bind HDL?
SRB1 and A1
What acute disease will physicians attempt to prevent during severe dyslipidemia?
acute pancreatitis
What causes familial hypercholesterolemia?
LDL receptor defect
What deleterious effect of statins can niacin exacerbate?
myopathy
What is the least potent statin?
fluvastatin
What are the two most potent statins?
atorvastatin
rosuvastatin
What is a side effect of patients taking high potency statins?
liver damage
What enzyme can niacin decrease the activity of?
hormone sensitive lipase
Which apolipoprotein can niacin activate?
A-I
