Atherosclerosis and lipoprotein Rx

Question 1

HMG coa inhibitors name s

Answer 1

statins

Question 2

statins moa

Answer 2

nhibits 3-hydroxy-3methylglutaryl coenzyme A
(HMG-CoA), the rate- limiting step in cholesterol
synthesis.

Resulting in a compensatory increase in the expression of LDL receptors in the live

Question 3

statin adrs

Answer 3

Myopathy (myositis orrhabdomyolysis)
Hepatotoxicity
New onset diabetes-reported in primary prevention trials
Memory loss- rare

Question 4

statin dental

Answer 4

Muscle weakness may
present as difficulty
brushing teeth or
weakness with chewing

Question 5

fibrates

Answer 5

Fenofibrate Available: PO
Fenofibric acid Available: PO
Gemfibrozil Available: PO

Question 6

fibrates moa

Answer 6

Agonist of peroxisome proliferator-activated receptor-α (PPARα) nuclear receptor. Increases transcription of lipoprotein lipase, resulting in reduction in VLDL and triglycerides, also increases LDL update and HDL synthesis

Question 7

fibrates adrs

Answer 7

Myopathy (more common in combo with statins)
Blurred vision
Hepatotoxicity
GI distress (abdominal pain)

Question 8

finbrates dental

Answer 8

Semisupine chair position
may help with GI distress
May cause dry mouth
Avoid dental light in
patient’s eyes if having
visual effects

Question 9

BABAs

Answer 9

Cholestyramine Available: PO (powder)
Colesevelam Available: PO
Colestipol Available: PO

Question 10

BABAs moa

Answer 10

Bind to bile in the intestine,
preventing resorption of bile
acid. Results in increased
uptake of LDL by liver to make
more bile acid

Question 11

BABAs ADRs

Answer 11

Significant GI distress- constipation, abdominal pain, nausea, dyspepsia

Elevations in triglycerides

Question 12

BABAs dental

Answer 12

semisupine for GI

Question 13

Absorption inhibitor

Answer 13

Ezetimibe

Question 14

Absorption inhibitor MOA

Answer 14

Blocks cholesterol absorption
in the intestine (duodenum)
by blocking transport protein
NPC1L1 in the brush border of
the enterocytes

Question 15

Ezetimibe ADRs

Answer 15

Side effects are rare
Diarrhea (4%)
Back pain (3%

Question 16

Ezetimibe dental

Answer 16

none

Question 17

niacin moa

Answer 17

Inhibits hepatic VLDL secretion.
Lowers serum Triglycerides and LDL and increases serum HDL

Question 18

niacin ADRs

Answer 18

Flushing
GI Distress
Hepatotoxicity
Impaired glucose tolerance
Elevations in uric acid levels (worsen gout)

Question 19

niacin dental

Answer 19

May prolong clotting
time, increasing the
risk of bleeding.

May cause dizziness so
use caution as patient
stands u

Question 20

ATP-citrate lyase (ACL) inhibitor

Answer 20

Bempedoic acid
Available: PO

Question 21

bempedoic acid moa

Answer 21

Inhibits ATP-citrate lyase
(ACL), two steps upstream of
HMG CoA reductase

Question 22

bempedoic acid adr

Answer 22

Hyperuricemia (gout)
Muscle spasms
Elevated liver enzymes

Question 23

bempedoic acid dental

Answer 23

none

Question 24

Proprotein subtilisin kexin type 9 (PCSK9) inhibitors

Answer 24

Alirocumab
Evolcumab
Available: SQ

Question 25

Alirocumab/ Evolcumab moa

Answer 25

Block the action of PCSK9
PCSK-9 promotes the degradation of LDL receptors.
Inhibition of PCSK-9 results in more active LDL receptors and lower serum LDL

Question 26

Alirocumab/ Evolcumab adrs

Answer 26

Side effects are rare
Injection site reaction (7-17%)
Diarrhea (5%)
Decreasing LDL too low (< 25mg/dL)

Question 27

Alirocumab/ Evolcumab dental

Answer 27

none