Antilipemic Drugs

Question 1

What are statin drugs used to treat?

Answer 1

Dyslipedemia; they help lower cholesterol and LDL levels

Question 1

Describe how statins work

Answer 1

There is an enzyme in the liver that is needed to make cholesterol. Statins inhibit this enzyme which reduces cholesterol production

Question 2

What are contraindications of statins?

Answer 2

Pregnancy and breastfeeding
Liver disorder (alcohol abuse or high liver enzyme levels)

Question 3

What drug interactions are there with statins?

Answer 3

-Grapefruit juice
- Warfarin
-Fibrates
-CYP3A4 Substrates (Macrolide antibiotics, azole antifungals, quinidine, verapamil, diltiazem, amlodipine)

Question 4

For which statin should you avoid food while taking?

Answer 4

Simvastatin

Question 5

For which statin do you have to take with food?

Answer 5

Lovastatin IR

Question 6

When should a patient take Lovastatin ER?

Answer 6

At bedtime

Question 7

When should a patient take Fluvastatin IR?

Answer 7

At bedtime

Question 8

Name the therapeutically dose equivalents of the statins?

Answer 8

Flu 80
Lov 40
Pra 40
Sim 20
Ator 10
Ros 5
Pit 2

Question 9

What are the potential side effects for Statin Drugs?

Answer 9

Musculoskeletal: Muscle cramps & myalgias
Dermatological: Rash & pruritis
Neurological: Headache
GI: Nausea, constipation, diarrhea, ab pain, farting, liver dysfunction

Question 10

What can you do while administering a statin drug to minimize the GI effects?

Answer 10

Administer with a glass of water or a meal

Question 11

What are the adverse of effects of Statin Drugs?

Answer 11

-Myopathies
-Rhabdomyolysis
-High liver enzyme levels

Question 12

What is Rhabdomyolysis?

Answer 12

A severe type of myopathy where there is a breakdown of muscle. Leads to high CK levels and myoglobins in the urine. Can lead to acute renal failure and be fatal

Question 13

What Statin side and adverse effects should be reported to the provider?

Answer 13

-Muscle aches and pains
-Darkening of urine
-Nausea, Vomiting

Question 14

When should Lovastatin be taken?

Answer 14

In the evening with a meal

Question 15

Which statins are significantly metabolized by CYP3A4?

Answer 15

-Lovastatin
-Simvastatin
-Atorvastatin

Question 16

How do Bile Acid Sequestrant Drugs work?

Answer 16

They bind to bile acids which prevents the cholesterol from being reabsorbed by the small intestine. Then it is excreted in the feces

Question 17

Name 3 Bile Acid Sequestrants

Answer 17

Colesevelam
Cholestyramine
Colestipol

Question 18

How do Fibrate Drugs work?

Answer 18

They stimulate a receptor that makes lipoprotein lipase which is an enzyme that breaks down choelsterol

Question 19

Name 3 Fibrate Drugs

Answer 19

-Fenofibrate
-Fenofibric Acid
-Gemfibrozil

Question 20

Should Gemfiborzil be given before or after meals? Why?

Answer 20

30 minutes before; food reduces the body’s exposure to the drug so it wont work as well

Question 21

What are contraindications for Bile Acid Sequestrants?

Answer 21

-Biliary & Bowel obstruction
-Pregnancy

Question 22

What are contraindications for Fibrates?

Answer 22

-Preexisting gallbladder disease
-Liver & kidney dysfunction
-Breastfeeding

Question 23

Why are statins best given at night?

Answer 23

The liver produces most cholesterol at night

Question 24

What medication class can cause urine to have a burnt odor?

Answer 24

Bile Acid Sequestrants (Colestipol & Cholestyramine)

Question 25

Can Ezetimibe be used during prengnancy?

Answer 25

Hell no

Question 26

Which antihyperlipidemic drug can be used with patients with organ transplantation or severe liver/kidney disease?

Answer 26

Colesevelam