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PHRM 844 > Antihyperlipidemics > Flashcards

Antihyperlipidemics Flashcards

1
Q

what are the two major lipids?

A

cholesterol and triglyceride

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2
Q

what do lipoproteins do?

A

transport cholesterol and triglycerides in blood

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3
Q

chylomicrons are made of mostly ____

A

triglycerides

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4
Q

VLDLs are made of mostly ___

A

triglycerides

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5
Q

LDLs are made of mostly ____

A

cholesterol

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6
Q

HDLs are made of mostly ___

A

proteins

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7
Q

Apo A-1

A

in HDL, reverse cholesterol transport

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8
Q

Apo B-100

A

in VLDL, IDL, LDL - is LDL receptor ligand and bad

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9
Q

Apo B-48

A

in chylomicrons - produced in intestine

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10
Q

Apo E

A

reverse cholesterol transport with HDL

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11
Q

Apo CII

A

in chylomicrons and VLDL
binds LPL to enhance TG lipolysis

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12
Q

LPL does what

A

breaks VLDL to LDL

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13
Q

HL does what

A

IDL to LDL

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14
Q

cholesterol synthesis pathway

A

acetoacetyl coa - HMG Coa - mevalonate - cholesterol

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15
Q

what ratio is key in assessing risk of CVD

A

total cholesterol to HDL
greater than 4.5 is increased risk CVD

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16
Q

hyperlipoproteinemia diseases

A

atherosclerosis, premature CAD, stroke

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17
Q

hypertriglyceridemia diseases

A

pancreatitis, xanthomas, CHD

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18
Q

MOA of bile acid resins

A

inhibit reabsorption of bile acids from intestine , up regulate LDL receptors in liver

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19
Q

bile acid resins side effects

A

constipation and bloating

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20
Q

bile acid resins drug interactions

A

acetaminophen, thiazides, ezetimibe, oral contraceptives, warfarin, digoxin, fibrates, TZDs, steroids

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21
Q

ezetimibe mechanism of action

A

inhibits cholesterol absorption from diet, inhibits NPC1L1

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22
Q

ezetimibe adverse effects

A

well tolerated, low incidence of muscle pain

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23
Q

statin mechanism of action

A

competitively inhibit HMG-CoA reductase the rate limiting step in cholesterol biosynthesis, upregulate LDL receptors so more hepatic uptake of LDL

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24
Q

HMG-CoA reductase inhibitors indications

A

hypercholesterolemia and after MI

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25
Q

prodrug statins

A

lovastatin and simvastatin

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26
Q

statin CYP 3A4 substrates

A

lovastatin, simvastatin, atorvastatin

27
Q

statin CYP 2C9 substrates

A

fluvastatin, rosuvastatin

28
Q

statin sulfation metabolism

A

pravastatin

29
Q

pitavastatin undergoes ____

A

enterohepatic recirculation

30
Q

statin adverse effects

A

skeletal muscle effects, rhabdomyolysis, hepatotoxicity, increased incidence of type 2 diabetes

31
Q

bempedoic acid is used for ___

A

adjunct to statins, heterozygous familial, ASCVD

32
Q

bempedopic acid side effect

33
Q

PCSCK9 MOA

A

inhibits degradation of PCSK9 receptors in liver
increase LDL-R and reduce LDL levels

34
Q

PCSK9 inhibitors directions

A

injection subq every 2 weeks

35
Q

inclisiran MOA

A

hybridizes PCSK9 mRNA and directs degradation

36
Q

incliserin used for

A

adjunct to statins in HeFH and ASCVD

37
Q

Apo B lipoprotien inhibitors use

A

homozygous familial

38
Q

apo B lipoprotein inhibitors drugs

A

lomitapide, mipomersen, evinacumab

39
Q

lomitapide MOA

A

inhibits assembly apo B by inhibiting MTTP, interferes with chylomicron and VLDL making

40
Q

lopitamide indication and warning

A

homozygous familial
liver damage risk - Rx program

41
Q

does lopitamide MOA require LDL-R

42
Q

mipomersen MOA

A

anti-sense oligonucleotide inhibitor of apo B100

43
Q

mipomersen indication and warning

A

homozygous familial
liver damage (hepatic steatosis)

44
Q

evinacumab indication and MOA

A

homozygous familial
increases LPL

45
Q

does evinacumab require LDL-R

46
Q

fibric acid MOA

A

PPAR-alpha activators
must undergo activation
reduce serum triglycerides

47
Q

fibric acid side effects

A

skeletal muscle / rhabdo - caution with statins

48
Q

fibric acid drug interaction

A

warfarin, increase effects

49
Q

niacin mechanism

A

reduce serum triglycerides, increase HDL

50
Q

niacin targets and actions

A

decrease fatty acid transport to liver
decrease triglyceride export via VLDL
increase HDL and reverse transport
decrease cholesterol via HDL transport

51
Q

niacin use

A

raising HDL

52
Q

niacin adverse effects

A

prostaglandin mediated vasodilation and flushing/itching
treat with ibuprofen or aspirin

53
Q

omega 3 indications

A

TGs over 500

54
Q

adverse effects omega 3

A

can increase LDL

55
Q

Friedwald Equation

A

calculates LDL-c
LDL = TC - HDL - TG/5

56
Q

high intensity statins

A

atorvastatin 40-80 mg
rosuvastatin 20-40 mg

57
Q

low intensity statins

A

simvastatin 10 mg
pravastatin 10-20 mg
lovastatin 20 mg
fluvastatin 20-40 mg

58
Q

hydrophilic statins

A

rosuvastatin and pravastatin

59
Q

simvastatin contraindications

A

-onazole, -omycin, gemfibrozil, danazol

60
Q

do not exceed 10mg simvastatin

A

verapamil
diltiazem

61
Q

do not exceed 20mg simvastatin

A

amiodarone
amlodipine

62
Q

fibrates contraindications

A

hx gallbladder disease
dialysis
persistent liver disease

63
Q

PCSK9 inhibitors adverse effects

A

influenza, injection site reaction

PHRM 844 (16 decks)

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