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Pharm EXAM 2 > chapter 10- dyslipidemia > Flashcards

chapter 10- dyslipidemia Flashcards

1
Q

what is dyslipidemia

A

high cholesterol

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2
Q

what component are triglycerides

A

a sugar

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3
Q

what is within a lipid-protein

A

cholesterol, phospholipid, triglyceride

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4
Q

what synthesizes lipids

A

the liver and intestine

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5
Q

what do lipids control

A

energy sources

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6
Q

what are the three most common diagnoses in the US

A

HTN, diabetes, high cholesterol

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7
Q

what is metabolic syndrome

A

Conditions that occur together that increase the risk of heart disease
-doubles it!

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8
Q

what are the conditions of metabolic syndrome

A

-Central or abdominal obesity
-increased triglycerides
-high LDL –lousy lipid
-low HDL – good lipid
-increased BP
-Increased glucose

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9
Q

what is dyslipidemia/hyperlipidemia a risk factor for

A
  • CAD
    -atherosclerosis
    -pathophysiologic effects
    -MI and ischemia
    -CVA
    -PAD
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10
Q

what is primary hyperlipidemia

A

genetic, mutation of the LDL receptor. 1/500 people have this.

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11
Q

what is secondary hyperlipidemia

A

caused by dietary habits and/or other diseases

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12
Q

symptoms of high cholesterol

A

-loose stool
-depression
-stomach distention
- poor appetite
-weight gain
-heart pain
-fatigue
-cholesterol pockets — normally seen by eyes
-aching pain in joints

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13
Q

what should total cholesterol be?
borderline?
high?

A

-less than 200 mg
-200 to 239 mg
-more than 240 mg

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14
Q

what should LDL cholesterol be?
Alright?
borderline?
high?
very high?

A

-less than 100 mg
-100-129 mg
-120-159
-160-189
-190 or above

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15
Q

what should HDL cholesterol be?
alright?
low?

A

-60 mg or higher
- 40-59 mg
- less than 40 mg

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16
Q

when should cholesterol panels be drawn

A

in the morning, after a fast

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17
Q

what is the Mediterranean diet

A

-olive oil
-legumes
-fruit and veggies
-fish
-dairy

18
Q

medications that affect cholesterol

A

-atenolol
-amiodarone
-prednisone
-diuretics

19
Q

what can be a solution for post-menopausal women

A

hormone replacement

20
Q

what food category can you increase in your diet

A

fiber

21
Q

how do HMG-CoA reductase inhibitors work
“statins”

A

decrease cholesterol production, decrease total cholesterol and LDL, VLDL, without affecting HDL– may actually increase

22
Q

common statins

A

ATORVASTATIN
-pravastatin
-lorostatin
-rosuvastatin
-simvastatin

23
Q

side effects of statins

A

MYALGIA –muscle dysfunction, pain, weakness, in the legs, will keep on med unless it can not be tolerated.
-nausea
-constipation/diarrhea

24
Q

what meds do statins interact with

A

mg+ antacids. “azole” antifungals, some antibiotics, cholestyramine

25
Q

when to give and what to avoid with statins

A

give in the evening that’s when synthesized
-no grapefruit or pomegranate
-red rice yeast
-vitamin B3
PREGNANCY — normally not given if possible
rhabdomyolysis or changes to liver enzymes!

26
Q

how do bile acid sequestrants work
what is the main one?

A

binds to bile acid in the intestine causing excretion, can not be recirculated in the liver, and makes the acid from cholesterol, lowering LDL.

cholestyramine

27
Q

pharmacokinetics of cholestyramine

A

not absorbed orally, unchanged in stool. will take effect within a week and reach peak within a month

28
Q

Side effects of cholestyramine

A

GI fullness, flatulence (gas), constipation/diarrhea

29
Q

what to know about the administration of cholestyramine

A

decreases absorption of other drugs: glipizide (DM), folic acid, propranolol, thiazide diuretics, thyroid hormone, warfarin
decreases: A, D, E, K
Fiber will increase the effect

GIVE 1 hour before or 4-6 HOURS AFTER other beds
ideally early morning or late night

30
Q

how do fibrates work?
common fibrates?

A

increase oxidation of fatty acids in the liver and muscle, decrease production of triglycerides, VLDL and increase HDL

fenofibrate and gemfibrozil

31
Q

common side effects and who cannot have them?

A

Gi discomfort, diarrhea, GALLSTONES

NOT FOR PEOPLE WITH GALLBLADDER ISSUES

32
Q

medication interactions with fenofibrate and gemfibrozil and when to take them

A

can enhance warfarin, increase kidney side effects with statins, decrease the effect of bile acid meds

Gemfibrozil should be taken on an empty stomach, 30 minutes before eating

33
Q

how do cholesterol absorption inhibitors meds work?
most common med?

A

inhibit the absorption of cholesterol in the intestine, leading to decreased levels in the liver, increasing clearance from the blood

EZETUNIBE

34
Q

side effects of ezetimibe

A

HA, diarrhea, nausea

35
Q

what is it normally taken with, and when should it not be taken

A

can be taken by itself or with a statin

should not be taken during pregnancy

36
Q

how do PCSK9 inhibitors work, and when are they used

A

inactivates the protein in the liver that regulates the lifespan of cholesterol. can cause a 60-70% decrease in LDL.

used on people with genetic hypercholesterol on max statin dose

37
Q

example of PCSK9 med, how it is administered, and side effects

A

alirocumab

sub Q every 2-4 weeks, doses vary

itching, nasopharyngitis and muscle pain

38
Q

how does niacin B3 work, side effects, and when can it not be used

A

boosts levels of HDL and lower triglycerides and LDL

S: facial flushing, stomach upset, diarrhea, RAISED BLOOD SUGAR

cant be used with liver issues, stomach ulcers, changes to glucose, muscle damage, low BP, heart rhythm changes

39
Q

main complaint of using Omega 3 fatty acids and what types are there

A

fishy aftertaste

-acid ethyl esters and carboxylic acids

40
Q

examples of combination therapy

A

Advicor: extended release of niacin and lovastatin
Simcor: simvastatin and niacin

Niacin dose can change within both

Pharm EXAM 2 (8 decks)

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