Antilipidemics Flashcards
The statin drugs are metabolized by the CY450 enzymes. If you are taking a drug that inhibits CYP450, would your serum statin level increase or decrease?
Increase
What is the most common side effect after initiating a statin therapy?
Myopathy (muscle weakness or soreness)
Why are most statins suppose to be taken at night?
To be effective during the highest production of cholesterol, between 2-4 am, when the upregulation of LDL receptors in the liver enhance clearance of LDL.
Which of the following best describes the MOA for evolocumab?
A. Decreased degradation of LDL receptors
B. Decreased hepatic production of VLDL
C. Decreased hepatic uptake of LDL
D. Prevention of absorption of dietary cholesterol
A. Evolocumab is a PCSK9 inhibitor. PCSK9 inhibitors are monoclonal antibodies that prevent LDL receptor degradation in the liver, resulting in increased removal of LDL from bloodstream. Most often used in patients with patients with insufficient LDL reduction in response to diet, exercise, and statin therapy.
Which of the following best describes the MOA for cholestyramine?
A. Activation of PPAR-a and LPL upregulation
B. Prevents absorption of dietary cholesterol
C. Prevents conversion of HGM CoA to mevolonic acid
D. Prevents reabsorption of bile acids
D.
A.
C.
B.
When starting a patient on a statin, education would include:
a) If they stop the medication their lipid levels can return to pretreatment levels.
b) Medication is a supplement to diet therapy and exercise.
c) If they have any muscle aches or pain, they should contact their provider.
d) All of the above
D.
Education of patients who are taking warfarin includes discussing their diet. Instructions include:
a) Do not eat any foods containing vitamin K.
b) Eat 35 grams of fiber daily.
c) Increase intake of iron-containing foods.
d) Avoid foods high in vitamin K .
D. Vitamin K: Warfarin interacts with vitamin K, which plays a role in blood clotting. It’s essential to maintain a consistent intake of vitamin K-rich foodsAvoid making big changes in your consumption of these foods, as it can affect the effectiveness of warfarin
Which of the following medications is an oral factor Xa inhibitor?
a) Warfarin (Coumadin)
b) Enoxaparin (Lovenox)
c) Ezetimibe (Zetia)
d) Apixaban (Eliquis)
D.
Which of the following classes of drugs should be avoided in HF?
a) Nitrates
b) Calcium channel blockers
c) Digoxin
d) Alpha-beta blockers
B. Calcium channel blockers should generally be avoided. These medications can negatively impact cardiac contractility and worsen HF symptoms.
A 51-year-old male has been told by his PCP to take an aspirin a day. Why would this be recommended?
a) Aspirin has antiplatelet activity and is used for the prevention of myocardial infarction.
b) He has a history of gastrointestinal (GI) bleed, and one aspirin a day can help prevent GI bleeding.
c) He has chronic kidney disease and this will help with the inflammation and pain.
d) Aspirin acidifies the urine and he needs this for prostate health.
A. Aspirin helps prevent blood clot formation by inhibiting platelet aggregation, which is crucial for reducing the risk of myocardial infarction (heart attack) and other cardiovascular events.
Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:
A. This is a parasympathetic response to the vasodilating effects of the drug.
B. Headaches are common side effects with these drugs. How severe are they?
C. This is associated with your smoking. Let’s work on having you stop smoking.
D. This is not related to your medication. Are you under a lot of stress?
B.
A patient had a deep vein thrombosis (DVT) and was on heparin and warfarin in the hospital and discharged home on warfarin. She asks her primary care nurse practitioner (NP) why she was getting both medications while in the hospital. The best response is to:
a) Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case.
b) Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness.
c) Encourage the patient to contact the customer service department at the hospital, as this was most likely a medication error during her admission.
d) Draw anticoagulation studies to make sure she does not have dangerously high bleeding times.
B.
