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Systemic Pharm Final > Anti-Lipid meds > Flashcards

Anti-Lipid meds Flashcards

1
Q

What is Atorvastatin (Lipitor) indicated for?

A

Statin HMG CoA reductase inhibitor Dyslipidemia/CVD Prevention Reduces risk of MI and stroke

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2
Q

What is fenofibrate indicated for?

A

Fibrate Prescribed either with statins or for statin intolerant patients. Hypertriglyceridemia Hypercholesterolemia

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3
Q

What is nicotinic acid indicated for?

A

Niacin Hypertriglyceridemia Hypercholesterolemia Mixed Dyslipidemia

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4
Q

What is ezetimibe indicated for?

A

Cholesterol absorption inhibitors Dyslipidemia

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5
Q

Most common types of dyslipidemias?

A

elevated LDL (IIa)

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6
Q

What is defined as Familial hypercholesterolemia and accounts for ocular signs of xanthelasma and arcus senilis

A

Type IIa

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7
Q

Desired total cholesterol levels

A

Below 200…. 240 is borderline

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8
Q

Desired LDL levels

A

Below 130… 160 is borderline

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9
Q

Desired HDL levels

A

Above 60… 30 is borderline

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10
Q

Lovastatin comes from what natural source?

A

Red yeast produces it as a secondary metabolite

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11
Q

Best selling pharmaseutical in 2003, long lasting statin

A

Atorvastatin

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12
Q

Short acting statin

A

Simvastatin

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13
Q

First statin on the market

A

Lovastatin

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14
Q

These two statins have CNS exposure

A

Lovastatin & Simvastatin

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15
Q

Two best statins for increasing HDL

A

Pravastatin & simvastatin

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16
Q

Two best statins for decreasing LDL

A

Atrovastatin & rosuvastatin

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17
Q

Best statin for reducing serum triglycerol

A

Atrovastatin

18
Q

Treatment of ocular side effects caused by niacin?

A

Stop use and symptoms resolve in 2 weeks

19
Q

Combination Drug Vytorin® composition?

A

ezetimibe + simvastatin

20
Q

What is the mechanism of action for Atorvastatin?

A

Antidyslipidemic Competitively inhibits HMG-CoA Reductase which is responsible for an early, rate-limiting step in cholesterol biosynthesis Increases hepatic LDL receptors, enhancing catabolism

21
Q

What are the 4 steps in the HMG CoA reductase inhibitor pathway?

A
22
Q

Atorvastatin side effects

A

ADVERSE EFFECTS

  • Common: nasopharyngitis, myalgia
  • Skeletal: myopathy (Creatine Kinase rises 10X)
  • Hepatic: impaired function associated w/ elevated serum transaminase levels; jaundice
  • CNS: amnesia
  • Ocular: diplopia, ptosis, pseudo-CME+ & blurred vision, elevated IOP, intraocular hemorrhage, cataracts (NSC and PSC)
23
Q

Atorvastatin drug interactions

A

•Cyclosporine, Erythromycin, Azole antifungals (Myopathy exacerbation) and grapefruit juice all inhibit metabolism by P450

24
Q

Contraindications for Atorvastatin

A

Azole antifungals

25
Q

Indications for Fenofibrate

A

Hypertriglyceridemia

Hypercholesterolemia

Given with statins and/or to patients who are statin intolerant

26
Q

Mechanism of action of Fenofibrate

A
  • Fibrates
  • Stimulates nuclear receptor PPAR which modulates transcription of insulin sensitive genes in liver, muscle and adipose tissue
  • Enhances HDL production; inhibits triglyceride synthesis and stimulates catabolism of triglyceride-rich lipoproteins
27
Q

Adverse effects of Fenofibrate

A

ADVERSE EFFECTS

•Common: Headache, rhinitis, flu syndrome

SERIOUS ADVERSE EFFECTS

  • Hypersensitivity: SJS, TEN
  • Hepatic: Hepatitis, cirrhosis
  • CV: Thromboembolism
  • Muscular: Myositis, myopathy, rhabdomyolysis
28
Q

Drug interactions with Fenofibrate

A
  • Acyclovir, Aminoglycosides, Cyclosporine, Ganciclovir (Impaired renal elimination)
  • Impaired metabolism of: Sulfonylureas
29
Q

Tryptophan is a precurser of what vitamin?

A

B3

30
Q

Indications for Niacin (B3)

A

Hypertriglyceridemia

Hypercholesterolemia

Mixed Dyslipidemia

31
Q

Most effective drug (?) in increasing HDL levels

A

Niacin (B3)

32
Q

Mechanism of action for Niacin

A
  • Vitamins/Nutritionals
  • Inhibits lipolysis in adipose tissue, resulting in reduced hepatic VLDL synthesis and production of LDLs in the plasma

20% reduction in LDL

33
Q

Steps of action for Niacin.

A

inhibits lipolysis in adipose tissue, resulting in decreased hepatic VLDL synthesis and production of LDLs in the plasma

34
Q

Side effects of Niacin

A

ADVERSE EFFECTS

•Common: Headache, pseudo cystoid macular edema, flushing due to PGD2 production, pruritus, hyperpigmentation, jaundice, xeroderma, toxic amblyopia, orthostatic hypotension

SERIOUS ADVERSE EFFECTS

  • Hepatic: Hepatotoxicity
  • CV: Arrhythmias

Starting ASA prior to administratoin can decrease PGD2

Ocular side effect go away 2 weeks after discontinuing

35
Q

Niacin drug interactions

A

Alpha-Blockers and Beta-Blockers have addative effect

36
Q

Contraindications for Niacin

A

Diabetes because it raises blood sugar

Surgery because it has and anti-platelet effect

37
Q

Mechanism of action of Ezetimibe

A

Cholesterol absorption inhibitor

•Inhibits dietary and biliary cholesterol absorption at small intestine brush border

38
Q

Side effects of Ezetimibe

A

ADVERSE EFFECTS

•Common: Sinusitis, influenza, diarrhea

SERIOUS ADVERSE EFFECTS

  • Hypersensitivity: Angioedema, anaphylaxis
  • Hepatic: Hepatitis
  • Heme: Thrombocytopenia
39
Q

Drug interactions of Ezetimibe

A

•Cyclosporine (combo may increase levels of both drugs)

40
Q

Contraindications of Ezetimibe

A

•Hepatic impairment

Systemic Pharm Final (12 decks)

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