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Pharm Midterm 1 > Antihyperlipidemics > Flashcards

Antihyperlipidemics Flashcards

1
Q

What lipid levels is CVD most closely associated with

A

Elevated LDL

Decreased HDL

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2
Q

If you decrease LDL by 30mg/dL how much does the RR of CHD decrease

A

30%

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3
Q

Aside from lipid profile, what are the 4 other risk factors for CHD

A

Smoking
HTN
Obesity
Diabetes

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4
Q

What are the 5 hyperlipidemia phenotypes

A

1 Hyperchylomicronemia
2A Hypercholesterolemia (LDL)
2B Combined hyperlipidemia (LDL and VLDL)
3 Dysbetalipoproteinemia (IDL)
4 Tryglyceridemia (VLDL)
5 Mixed hypertriglyceridemia (CM and VLDL

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5
Q

Why is secondary hyperlipidemia more prevalent than primary

A

Sedentary lifestyle

Excess fats in diet

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6
Q

What are the Statins (HMG-CoA Reductase inhibitors) in decreasing potency

A 
Rosuvastatin	
Atorvastatin	
Simvastatin	
Fluvastatin	
Lovastatin	
Pravastatin
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7
Q

Which is the only drug in the niacin class

A

Niacin

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8
Q

What are the Fibrate Derivatives

A

Gemfibrozil

Fenofibrate

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9
Q

What are the Bile Acid Binding Resins

A

Cholestyramine
Colestipol
Colesevelam

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10
Q

What are the Cholesterol absorption inhibitors

A

Ezetimibe

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11
Q

What are the omega-3 FAs

A

EPA
DHA
Lovasa

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12
Q

DOC for LDL reduction

A

Statins

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13
Q

Contraindicated in Pregnancy

A

Statins - Category X

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14
Q

Given as Adjuvant with statins

A

Niacin

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15
Q

DOC in pregnancy and children

A

Bile acid binding resins (Category B)

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16
Q

What do statins do

A

Increase endothelial function

Decrease platelet aggregation, inflammation, plasma CRP and LDL

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17
Q

How do statins work

A

Competitive inhibition of HMG-CoA Reductase
Decrease chol synth
Upregulate LDLr - More LDL clearance

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18
Q

What can statins used for

A

Decrease CV mortality

Not as good for FH

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19
Q

Statins are most effective when combined with

A

Resins
Niacin
Ezetimibe

20
Q

Main AE for Statins

A

Elevated Aminotransferases (LFTs 3x elevated)
Myopathy
Rhabdomyolysis
Myoglobinuria

21
Q

Statins combined with what increases the incidence of Myopathy and Rhabdomyolysis

A

Fibrate Derivatives

22
Q

What is the most effective drug at increasing HDL

A

Niacin

23
Q

What is the only drug that decreases Lp(a)

A

Niacin

24
Q

Which drug decreases VLDL, LDL and La(a)

A

Niacin

25
Q

Mechanism of Niacin action

A 
Activate Gi
Inhibit HSL, TAG synth, VLDL
Activate LPL
Decrease fibrinogen
Increase tPa
26
Q

Main Niacin AE

A 
Acanthosis nigricans
Hepatotoxicity
Hyperglycemia (insulin resistance)
Cutaneous flush
Pruritis, rash
Gout
27
Q

What do fibrates do

A

Decrease TAGs
Decrease VLDL
Increase HDL

28
Q

What do Fibrates act on

A

Activate PPAR-alpha

29
Q

What do fibrates do in 2B

A

Increase LDL

Decrease TAG

30
Q

When do you give Fibrates

A 
3 Dysbetalipoproteinemia (IDL)
4 Tryglyceridemia (VLDL)
31
Q

Who gets myositis with fibrates

A

Renal insufficiency

32
Q

What can cause cholelithiasis

A

Fibrates

33
Q

Which class of drugs is completely excreted in feces

A

Bile acid binding resins

34
Q

Which class of drug is only useful in pts with isolated high LDL

A

Bile acid binding resins

35
Q

What is contraindicated if there is increased TAGs

A

Bile acid binding resins

36
Q

Which Bile acid binding resins has fewer AE

A

Colesevelam

37
Q

Which class of drugs may decrease fat soluble vit absorption

A

Bile acid binding resins

38
Q

What do you combine Bile acid binding resins with

A

Statins or Niacin

39
Q

How do Bile acid binding resins work

A

Bind anionic bile acids (prevent reabsorption)
Decrease chol
Increase LDLr
Increase HDL

40
Q

What does Ezetimibe do

A

Inhibit chol absorption
Decrease LDL
Increase HDL

41
Q

How does Exetimibe work

A

Inhibit intestinal transport of chol
Decrease CM
Upregulate LDLr

42
Q

Ezetimibe AE

A

Impaired liver function
Myositis
Increase chol synth

43
Q

What drugs cause myositis

A

Gemfibrozil
Fenofibrate
Ezetimibe

44
Q

What drugs can increase HDL long term

A

Omega-3s

45
Q

How do omega-3s work

A

Decrease TAG

Increase FA oxidation

46
Q

When do you give omega-3s

A

Adults

>500mg/dL TAGs

47
Q

Omega-3 AEs

A

Increase total LDL

Pharm Midterm 1 (36 decks)

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