Cardio: Fibrates, Niacin

Question 1

The main triglyceride-carrying molecules in the blood are ____________.

Answer 1

chylomicrons and VLDL

Question 2

What drug works by upregulating lipoprotein lipase?

Answer 2

Gemfibrozil; it does so by activating the PPAR-alpha receptor(Think of the guy burning the PPAR PaPeRs to signal more triglycerides down from the VLDL airship to help protect from the gemfibrozil jellyfish attack.)

Question 3

After stimulating lipoprotein lipase, gemfibrozil ultimately _____________.

Answer 3

lowers VLDL levels (and consequently LDL levels); they also increase HDL levels (Think of the VLDL airship sinking with the jellyfish on top; the LDL boat sinking; and the HDL submarine being raised out of the water.)

Question 4

When given with statins, gemfibrozil increases risk of ___________.

Answer 4

myopathy

Question 5

What is the most potent HDL-raising medication?

Answer 5

Niacin (just like the Loch Niacin monster raising the HDL submarine more than any other drug)

Question 6

In addition to raising HDL, niacin also _______________.

Answer 6

inhibits release of VLDL (just like the other Loch Niacin monster in the background who is biting the VLDL airship)

Question 7

Taking ____________ before taking niacin can reduce the most common side effect of niacin therapy.

Answer 7

aspirin (because flushing is mediated by prostaglandins)

Question 8

Niacin has what two side effects that are similar to thiazides?

Answer 8

Hyperglycemia (the diver throwing candy into the air) and hyperuricemia (the diver knitting with yellow needles)

Question 9

How does fish oil work?

Answer 9

It inhibits the production of triglycerides and VLDL (think of the fish with oil trails swimming among the flotsam of triglycerides)