Anti-Hyperlipidemics I

Question 1

statins

Answer 1

HMG CoA reductase inhibitors

Question 2

niacin

Answer 2

nicitonic acid and vit B3

inhibit lipolysis of triglycerides in adipose tissue - reduce circulating FFAs

Question 3

fibric acid derivatives

Answer 3

fenofibrate
gemfibrozil

PPAR-alpha agonists

• regulate expression of lipoproteins
• increased expression of LPL

Question 4

fenofibrate

Answer 4

fibric acid derivative

Question 5

gemfibrozil

Answer 5

fibric acid derivative

Question 6

cholestyramine

Answer 6

bile acid sequestrants

Question 7

colesevelam

Answer 7

bile acid sequesterants

Question 8

colestipol

Answer 8

bile acid sequestrants

Question 9

resins

Answer 9

bile acid sequesterants

Question 10

ezetimibe

Answer 10

cholesterol absorption inhibitor

Question 11

new tx for homozygous familial hypercholesterolemia

Answer 11

lomitapide

mipomersen

Question 12

hyperlipidemia

Answer 12

• elevated total cholesterol, LDL, triglycerides

- decreased HDL

Question 13

hyperlipidemia pathology

Answer 13

LDL into subendo space
-oxidized
-increased plasminogen inhibitor
-endothelin
inhibited NO
-accumulation of cholesterol
-inflammation
-rupture of plaque

Question 14

desired lipid levels

Answer 14

total cholesterol - 200/240
LDL - 100/130/160/190
HDL 40/60

Question 15

NCEP ATPIII

Answer 15

guidelines for treatment of hyperlipidemia

goals for LDL levels

Question 16

risk equivalents

Answer 16

CAD
PAD
AAA
DM

Question 17

risk factors

Answer 17

age
family history
cigarette smoking
HTN
low HDL

Question 18

pregnancy

Answer 18

no statins

Question 19

CYP3A4

Answer 19

lovastatin
simvastatin
atorvastatin

Question 20

CYP2C9

Answer 20

fluvastatin

rosuvastatin

Question 21

not metabolized by CYP

Answer 21

pravastatin

Question 22

cutaneous flush

Answer 22

prostaglandin mediated with niacin

Question 23

cholelithiasis

Answer 23

with fibrates

Question 24

rhabdomyolysis

Answer 24

fibrates and statins

Question 25

fibrate drug interaction

Answer 25

warfarin

statins

Question 26

bile acid sequestrants

Answer 26

bind bile acid and increase excretion

increases LDL clearance

impairs drug absorption

Question 27

cholesterol absorption inhibitors

Answer 27

ezetimibe
-inhibit NPC1L1 - inhibit absorption of cholesterol and plant sterols

avoid giving with bile acid sequestrants

Question 28

statins cause

Answer 28

LDL decrease

Question 29

fibrates cause

Answer 29

TG decrease

Question 30

niacin causes

Answer 30

HDL increase

Question 31

bile acid sequestrants cause

Answer 31

LDL decrease

Question 32

high intensity statin

Answer 32

atorvastatin

rosuvastatin

Question 33

low intensity statin

Answer 33

simvastatin
pravastatin
lovastatin

Question 34

homozygous familial hypercholesterolemia

Answer 34

defect in LDL receptor

Tx - mipomersen
lomitapide

Question 35

mipomersen

Answer 35

inhibit apoB100 synthesis

Question 36

lomitapide

Answer 36

inhibit microsomal triglyceride transfer protein

prevents assembly of apoB

pregnancy contraindicated***

Question 37

atorvastatin

Answer 37

long half life

Question 38

pravastatin

Answer 38

no drug rxns - no CYP metabolism

Question 39

statin adverse

Answer 39

liver enzyme increase
creatine kinase increase - muscle

NOT in pregnant women

Question 40

cutaneous flushing

Answer 40

take aspirin before niacin to stop this