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Pharm > Cardiopulmonary: Hyperlipidemia > Flashcards

Cardiopulmonary: Hyperlipidemia Flashcards

1
Q

What does ASCVD risk calculator take into account? (9)

A 
gender
race
age
hdl
total cholesterol
dm
treatment for bp
systolic bp
smoking status
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2
Q

Depending on risk factors or PMH, treatment will be either

A

life style mod, moderate intensity statins, or high intensity statins

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3
Q

The foundation of ASCVD prevention

A

heart healthy lifestyle habits

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4
Q

For adults who are candidates for statins and have ASCVD, who should be getting a high intensity vs a moderate intensity statin?

A

high intensity - those younger then 75

moderate intensity - those older than 75 OR those who are not candidates for high intensity statin

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5
Q

For adults who have LDL greater than or equal to 190 but do not have an ASCVD, what intensity statin?

A

high

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6
Q

For adults age 40-75 who are diabetic but without ASCVD and have LDL < 190, what treatment?

A

moderate intensity statin

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7
Q

For adults age 40-75 who are diabetic but without ASCVD, have LDL < 190, but have 10-y ASCVD risk at or above 7.5%, what treatment?

A

high intensity statin

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8
Q

HMG-CoA Reductase Inhibitors

A

Statins

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9
Q

The MoA of statins

A

Statins inhibit HMG-CoA reductase which is the enzyme involved in cholesterol formation.

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10
Q

high intensity statins do what

A

daily dose lowers LDL cholesterol by approximately greater than or equal to 50%

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11
Q

moderate intensity statin

A

daily dose lowers LDL cholesterol by approximately 30-<50%

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12
Q

4 pharmacological treatments for hyperlipidemia

A

HMG CoA Reductase Inhibitors (statins)
fibrates
bile acid sequestrants
nicotinic acid (niacin)

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13
Q

Suffix for statins

A

-statin

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14
Q

low intensity statins lower LDL by

A

< 30%

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15
Q

moderate intensity statins lower LDL by

A

30-50%

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16
Q

high intensity statins lower LDL by

A

greater than or equal to 50%

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17
Q

high intensity statin examples

A

atorvastatin

rosuvastatin

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18
Q

low intensity statin examples

A

pravastatin

lovastatin

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19
Q

why should you be aggressive with statins?

A

we know statins have a good effect on cardiac health and in the setting of DM. if someone has a risk of MI, start out with atorvastatin 80mg for a short time.

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20
Q

which statins are water soluble, and thus less myopathic?

A

pravastatin

rosuvastatin

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21
Q

what organ abnormalities can arrive from statins?

A

liver

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22
Q

if patient on statin starts to have AEs/the doses are getting too high, what should you do?

A

switch to a water soluble statin like rosuvastatin because the risk for myalgias will go down

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23
Q

Myalgias and myopathies from statins may lead to

A

rhabdomyolysis or renal failure

24
Q

Myalgias and myopathies from statins are depending on

A

dose

25
Q

characteristic of myalgia/myopathy from a statin

A

pain is not brought on by activity

26
Q

Patient on statins comes to you and reports muscle pain/tenderness/weakness

A

Assess and ask about malaise/fever

27
Q

why are there a lot of drug/food interactions with statin?

A

because it is metabolized via CYP 3A4

28
Q

what food to avoid on statins?

A

grapefruit juice

29
Q

which 2 statins have the most interactions?

A

simvastatin

atorvastatin

30
Q

Statin is a prodrug or APC?

A

APC

31
Q

people who take fibrates typically have what?

A

familial hypertriglyceridemia

32
Q

Fibrate drugs, 2 examples

A

gemfibrozil

fenofibrate

33
Q

Most concerning side effect of fibrates

A

myopathy

increased risk with concurrent use of statins

34
Q

what labs should you get for someone on fibrates?

A

LFTs

INRs if they’re on warfarin

35
Q

risk of using fibrate and statin together

A

myopathies, fatal at high doses

36
Q

What drugs should be avoided when taking fibrates?

A

statins

warfarin

37
Q

fibrates and warfarin

A

increases warfarin conc by 30%

38
Q

Bile acid sequestrants AKA

A

resins

39
Q

Examples of bile acid sequestrants (3)

A

cholestyramine
colestipol
colesevelam

40
Q

any time you see a med that alters absorption (like a resin) you should consider

A

what else they’re taking because these alter the environment of the GI tract

41
Q

What discourages use of bile acid sequestrants?

A

side effect profile

42
Q

Nicotinic acid aka

A

niacin

43
Q

Availability of nicotinic acid

A

OTC or Rx

44
Q

side effects of nicotinic acid

A

flushing
tingling
itching

45
Q

toxicity: nicotinic acid

When does it happen

A

hepatotoxicity possible when changing from ER to IR

46
Q

HDL ideally

A

> 60

47
Q

total cholesterol ideally

A

< 200

48
Q

what meds have to be dose reduced with simvastatin?

A

amiodarone

diltiazem

49
Q

rosuvastatin and atorvastatin are used for both

A

high and moderate intensity

50
Q

pravastatin and can be used as

A

moderate and low intensity

51
Q

rhabdomyolysis is a rare ADR of statins, T or F

A

T

52
Q

fat soluble statins are more or less likely too cause rhabdomyolysis/myopathy?

A

more likely

53
Q

if a person on a statin complains of muscle pain brought on nothing, what to do?

A

LFTs, CK, fluids, take a break from med

54
Q

when should LFTs/bili be done in the patient with statins?

A

when started, with dose change, and then yearly. unless muscle pain occurs.

55
Q

which population should be started on statins at a lower dose?

A

asian. higher risk for myopathies/myalgias.

56
Q

pt education for bile acid resins

A

need to be taken separately from other medications because they affect how other meds are absorbed

Pharm (31 decks)

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