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pharm > antilipemic drugs > Flashcards

antilipemic drugs Flashcards

1
Q

what are the 2 forms of lipids in blood

A

triglycerides and cholesterol

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2
Q

what are lipoproteins

A

combination of triglyceride or cholesterol with apolipoprotein

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3
Q

VLDL are produced by

A

liver

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4
Q

HDL are responsible for

A

recycling of good cholesterol

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5
Q

risk of coronary heart disease is 3x greater with cholesterol levels of

A

5.2mmol/l

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6
Q

dyslipidemia treatments

A

meds, nondrug means (exercise)

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7
Q

what is the Framingham risk score

A

measures the ratio of HDL to LDL

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8
Q

first-line therapy for hypercholesterolemia

A

statins (HMG- CoA)

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9
Q

statins action

A

-reduces plasma concentrations of LDL by 30 -40%
- decrease in plasma triglycerides by 10-30%
- increase in HDL by 2-15%

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10
Q

statin examples

A

atorvastatin (Lipitor) and rosuvastatin calcium (Crestor)

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11
Q

statin MOA

A

-lowers blood cholesterol levels by decrease rate of production.
-less cholesterol produced= increase in number of LDL receptors to recycle LDL from circulation.

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12
Q

statin adverse effects

A

mild Gi disturbances
rash
headache
myopathy- most common. muscle pain. can lead to rhabdomyolysis

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13
Q

when do you not use statins

A

pts with elevated liver enzymes or liver disease

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14
Q

rhabdomyolysis

A

breakdown of muscle protein and can result in myoglobinuria.
usually reversible early with discontinuation of statin.

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15
Q

myoglobinuria

A

urinary elimination of the muscle protein myoglobin.
can lead to acute kidney injury or death.

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16
Q

symptoms to report immediately when taking statins

A

muscle soreness or changes in urine color (tea colored)

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17
Q

statin interactions

A
  • oral anticoagulants
  • drugs metabolized by CYP3A4 enzyme
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18
Q

what are the drugs metabolized by CYP3A4

A

erythromycin, azole antifungals, quinidine sulphate, verapamil hcl, diltiazem hcl, HIV and hep C protease inhibitors, amiodarone hcl, cyclosporine, clarithromycin, amlodipine

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19
Q

grapefruit juice and statins

A

can increase risk of myopathy

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20
Q

atorvastatin calcium and rosuvastatin MOA

A

lowers LDL and triglyceride levels and raises good cholesterol and HDL
dosed once daily with evening meal

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21
Q

bile acid sequestrant example

A

cholestyramine resin (Olestyr)

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22
Q

bile acid sequestrant MOA

A

prevent bile acid reabsorption from small intestine

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23
Q

what do bile acids do

A

absorption of cholesterol

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24
Q

the more bile acids excreted…..

A

the more the liver converts cholesterol to bile acids, reducing cholesterol in the liver and circulation.

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25
Q

bile acid sequestrates indications

A

-type 2 hyperlipoproteinemia
- relief of pruritus associated with partial biliary obstruction
- may be used along statins

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26
Q

bile acid sequestrants adverse effects

A

-constipation
- heartburn, nausea, belching, bloating. take fibre and increase fluid to relieve symptoms.

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27
Q

overdose of bile acid can cause

A

bowel obstruction

28
Q

when should drugs be taken with bile acid sequestrants

A

1 hr before or 4-6 hours after

29
Q

high doses of bile acid sequestrant decreases the absorption of

A

fat soluble vitamins (A,E,D,K)

30
Q

contraindications of cholestyramine resin

A

known hypersensitivity, phenylketonuria or complete biliary obstruction, pregnancy

31
Q

cholestyramine resin can also treat

A

loose bowel movements

32
Q

niacin is also known as

A

vitamin b3

33
Q

lipid-lowering properties require much ____ doses when used as a vitamin

A

higher

34
Q

niacin is given as an adjunct to

A

statins

35
Q

niacin MOA

A

inhibits lipolysis in adipose tissue, decreases esterification of triglycerides in the liver and increases the activity of lipoprotein lipase.

36
Q

resultant effect

A

decreased triglyceride level, decreased LDL and increase HDL

37
Q

niacin also stimulates the fibrinolytic system to…

A

break down fibrin clots

38
Q

niacin indications

A
  • lowers triglycerides and LDLs
    -increases HDLs
    therapeutic effects after 1-4 days
    -max effects on 1-3 weeks
39
Q

niacin contraindications

A

peptic ulcer idsease, hypertenstion, active hemorrhagic process, gout

40
Q

niacin adverse effects

A

flushing, pruritus, GI distress

41
Q

how to reduce flushing with niacin

A

take aspirin 30min prior to taking niacin

42
Q

fibric acid derivatives MOA

A

-activate lipoprotein lipase which breaks down cholesterol
-suppresses release of free fatty acid form adipose
-inhibit the synthesis of triglycerides
-increases cholesterol into bile.

43
Q

how much does gemfibrozil increase HDL levels by

A

25%

44
Q

fibric acid derivatives contraindications

A

drug allergy, severe liver or kidney disease, cirrhosis, gallbladder disease, pregnancy

45
Q

fibric acid derivatives adverse effects

A

abdominal discomfort, diarrhea, nausea, blurred vision, headache, risk of gallstones, prolonged prothrombin time, increased enzyme levels.

46
Q

gemfibrozil interactions

A

enhances action of oral anticoagulants (increased bleeding time with warfarin before clotting).

47
Q

fibric acids are all given with a

A

statin

48
Q

fibric acid derivatives and statins increase the risk of

A

myositis, myalgia and rhabdomyolysis

49
Q

lab test results on gemfibrozil

A

-decreased hemoglobin, hematocrit and WBC count
- increased aspartate, aminotransferase, activated clotting time, lactate dehydrogenase level and bilirubin level

50
Q

example of cholesterol absorption inhibitor

A

ezetimibe (ezetrol)

51
Q

ezetimbe MOA

A

-inhibits absorption of cholesterol and related sterols from the small intestine
- results in lower LDL, apolipoprotein and triglycerides
-increases HDL
-can be used as monotherapy or combined with a statin

52
Q

garlic is used as an

A

antispasmodic, antiseptic, antibacterial, antiviral, antihypertensive, anti platelet, lipid reducer

53
Q

garlic adverse effects

A

dermatitis, vomiting, diarrhea, anorexia, flatulence, anti platelet activity

54
Q

garlic interactions

A

warfarin, diazepam, protease inhibitors. can enahance bleeding with NSAIDS

55
Q

flax uses

A

atherosclerosis, hypercholesterolemia, hypertriglyceridemia, GI distress, menopause symptoms, bladder inflammation

56
Q

flax may cause

A

diarrhea, allergic reaction

57
Q

flax interactions

A

antihyperglycemic drugs, anticoagulant drugs

58
Q

omega 3 fatty acids are used to

A

reduce cholesterol

59
Q

omega 3 fatty acids may cause

A

rash, belching, allergic reactions

60
Q

omega 3 fatty acids interactions

A

anticoagulant drugs

61
Q

omega 3 fatty acids are contraindicated in

A

pregnancy

62
Q

contraindications of antilipemic drugs

A

biliary obstruction, liver dysfunction

63
Q

patients on long-term therapy may need supplemental _____

A

fat soluble vitamins (A,D,E,K)

64
Q

when should you take other medications with antilipemics

A

1 hr before or 4-6 hours after meals

65
Q

to minimize effects of niacin

A

start on a low initial dose and increase gradually. take meds with meals

66
Q

adverse effects to report while taking antilipemics

A

GI upset, constipation, abnormal bleeding, yellow skin

67
Q
A

pharm (21 decks)

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