anti hyperlipidemics

Question 1

Half life of statin

Answer 1

1-3 hours

exceptions: atorvastatin: 14 hrs
rosuvastatin: 19 hrs

Question 2

CYP3A4

Answer 2

Lovastatin, simvastatin, atrovastatin

Question 3

CYP2C9

Answer 3

Fluvastatin rosuvvastain

Question 4

Adverse drugs reactions of statins

Answer 4

1. Creatine kinase activity may increase
2. Rhabdomyolysis
3. Myopathy

Question 5

Contraindications of statins

Answer 5

Pregnancy and liver disease

Question 6

Niacin MOA

Answer 6

Inhibits hormone sensitive lipase
Reduces circulating free FAs
Increases excretion of cholesterol in bile

Question 7

Niacin adverse drug reactions

Answer 7

Cutaenous flush and feeling of warmth
Pruritus
Hepatotoxicity

Question 8

Niacin contraindications

Answer 8

Hepatic disease
Active peptic ulcer
Diabetes- use caution

Question 9

Fibric acid derivatives

Answer 9

Gemfibrozil

Fenofibrate

Question 10

Fibrates MOA

Answer 10

PPARα agonists, regulates expression of proteins involved in lipoprotein structure and function, increased expression of LPL

Question 11

ADRs of fibrates

Answer 11

• Lithiasis: formation or presence of calculi due to increased biliary cholesterol excretion. Pts are predisposed to the formation of gallstones
• Muscle, myositis
• Myopathy

Question 12

Fibrate contraindications

Answer 12

• Pregnancy

- Hepatic and renal dysfunction

Question 13

Fibrate drug/drug interactions

Answer 13

• Potentiates action of warfarin- increased risk of bleeding

- Statins- increased risk of rhabdomyolysis

Question 14

resins agents

Answer 14

colestipol
cholestyramine
colesevelam

Question 15

resin MOA

Answer 15

Increases the excretion of bile acids, enhancing the conversion of cholesterol to bile acids

The decline in cholesterol stimulates an increase in hepatic LDL receptor, which enhances LDL clearance

Question 16

Primary hypercholesterolemia tx

Answer 16

resins

Question 17

Resin PK

Answer 17

water insoluble: not absorbed and totally excreted in the feces

Question 18

Resin ADRs

Answer 18

• Gastrointestinal effects

- Impaired ADEK absorption

Question 19

Cholesterol absorption inhibitor agent

Answer 19

ezetimibe

Question 20

ezetimibe MOA

Answer 20

inhibits transport protein NPC1- inhibits absorption of cholesterol and phytosterols

Question 21

ezetimibe PK

Answer 21

water insoluble
excreted in feces
t1/2 22 hours

Question 22

ezetimibe ADRs

Answer 22

diarrhea

Question 23

ezetimibe DDI

Answer 23

avoid administration with bile acid sequestrants

Question 24

High effect on LDL

Answer 24

statins and bile acid sequestrants

Question 25

High effect on TGs

Answer 25

fibrates

Question 26

high effect on HDL

Answer 26

niacin

Question 27

high intensity statins

Answer 27

atrovastatin and rosuvastatin

Question 28

Prototype of LMWH

Answer 28

enoxaparin (lovenox)

Question 29

thrombolytic drugs

Answer 29

Alteplase
Reteplase
Tenecteplase
Streptokinase