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Kol- Pharm 323 Spring > Cholesterol > Flashcards

Cholesterol Flashcards

1
Q

How is Cholesterol made? What increase cholesterol production?

A
  • Made by liver all the time but increases when we eat saturated fat
  • Liver uses the Enzyme HMG CO-A to make more cholesterol
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2
Q

Name the 3 different types of cholesterol

A

VLDL
LDL
HDL

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3
Q

This kind of cholesterol delivers triglycerides to adipose and is linked to CAD/pancreatitis

A

VLDL

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4
Q

This cholesterol is a bad guy!

-when demand for cholesterol increases, cells increase # of _____ receptors and cell takes in more

A

LDL!

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5
Q

This cholesterol is good, is associated with the removal of cholesterol, and reduces risk of CAD

A

HDL

happy

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6
Q

2 strategies to drug therapy for lipid disorders

A
  1. decrease LDL

2. decrease triglycerides

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7
Q

The goal of treating lipid disorder is to prevent _____ and ______

A

Prevent atherosclerosis and CAD

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8
Q

What is the Framingham risk prediction score? What is it based on?

A

predicts risk of CAD based on Age, gender, total CHO, smoker, HDL, BP

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9
Q

Modifiable changes to prevent CAD/decrease cholesterol?

A

Diet (low saturated fat) ; exercise; weight control; smoking cessation

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10
Q

Diabetics are at _____ risk for developing CAD

A

equivalent

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11
Q

Long term concerns for managing high cholesterol?

A
  • Metabolic Syndrome

- Life-long treatment

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12
Q

prototype for HMG-CoA Reductase Inhibitors aka “Statins”

A

atorvastatin (Lipitor)

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13
Q

Which drug is 1st line therapy for Lipid disorders?

A

atorvastatin (Lipitor)

HMG-CoA Reductase Inhibitors aka “Statins”

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14
Q

How does atorvastatin (Lipitor) decrease mortality?

A

better plaque stability, decrease inflammation, slower progression of CAD, improve endothelial BV fxn (dilate better), decrease Afib, Decrease clots

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15
Q

which drug is MOST effective at lowering LDL and Total Cholesterol?

A

atorvastatin (Lipitor)

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16
Q

Which drug do we give to diabetics even when their LDL is normal b/c it is so effective at prevnting CV events?

A

atorvastatin (Lipitor)

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17
Q

How does atorvastatin (Lipitor) fxn?

A
  • Inhibit cholesterol synthesis in the liver
  • Stimulate hepatocytes to produce more LDL receptors
  • LDL receptors remove the LDL from the blood
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18
Q

What time of day should atorvastatin (Lipitor) be given?

A

night time!

That is when we make most of our cholesterol

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19
Q

Common side effects of atorvastatin (Lipitor)?

A

-headache, rash, memory loss, GI disturbance

20
Q

Rare but serious side effects of atorvastatin (Lipitor)?

A
  1. Hepatotoxicity (elevated LFT)
  2. Myopthathy/Rhabdomyolysis (elevated CK)
  3. Increase cataract occurence
21
Q

Who is not taking atorvastatin (Lipitor)

A
  1. pregnant

2. liver disease

22
Q

Drug drug interactions with atorvastatin (Lipitor)?

A
  • CYP34A: grapefruit, azoles, erythromycin, amiodarone

- increase SE with other lipid lowering drugs

23
Q

Prototype for Bile-Acid Sequestrants

A

colesevelam (Welchol)

24
Q

how does colesevelam (Welchol) function?

A
  • Biologically inert
  • BIND to bile acids to form complexes that are excreted
  • Since bile acids are made from cholesterol
  • Liver makes more bile acids using LDL
  • Increases LDL receptors to uptake more LDL
25
Q

2 lipid lowering drugs that only work in GI tract?

A

colesevelam (Welchol)

Ezetimibe (Zetia)–> small intestine

26
Q

Side effects of colesevelam (Welchol)

A

Bile-Acid Sequestrant

GI only !
-constipation, bloating, indigestion

27
Q

How to administer colesevelam (Welchol)?

A

Bile-Acid Sequestrant

Administer with food + H20

28
Q

Prototype for Cholesterol Absorption Inhibitor?

A

Ezetimibe (Zetia)

29
Q

How does Ezetimibe (Zetia) fxn?

A

Cholesterol Absorption Inhibitor

  • Blocks cholesterol absorption in the small intestine
  • Also blocks cholesterol secreted in bile

*Works only in GI tract

30
Q

3 lipid lowering drugs causing hepatotoxicity?

A
  1. atorvastatin (Lipitor) HMG-CoA Reductase Inhibitors aka “Statins”
  2. gemfibrozil (Lopid) Fibric Acid Derivatives (Fibrates)
  3. Ezetimibe (Zetia) Cholesterol Absorption Inhibitor
31
Q

combining Ezetimibe (Zetia) with ______ will increase hepatotoxicity

A

statin!

32
Q

Does Ezetimibe (Zetia) have side effects?

A

they are = to the placebo in trials

+ statin = hepatotoxicity

33
Q

what is vytorin?

A
  • ezetimibe (Zetia) ( Cholesterol Absorption Inhibitor)+ simvistatin (HMG-CoA Reductase Inhibitors)
  • —>blocks from food + synthesis
34
Q

prototype for Fibric Acid Derivatives (Fibrates)

A

gemfibrozil (Lopid)

35
Q

how does gemfibrozil (Lopid) fxn?

A

accelerate the clearance of VLDLs

36
Q

drug that is most effective for lowering Triglyceride levels and has little to no effect on LDL?

A

gemfibrozil (Lopid)

(Fibric Acid Derivatives (Fibrates))

37
Q

side effects of gemfibrozil (Lopid) ?

A

Fibric Acid Derivatives (Fibrates)

  • Rash and GI upset
  • Increased risk of gallstones
  • Myopathy
  • Hepatotoxicity
38
Q

2 drug drug interaction with gemfibrozil (Lopid) ?

A

Fibric Acid Derivatives (Fibrates)
Warfarin: Increase risk of bleeding
Statins: increased risk of rhabdo

39
Q

prototype for Monoclonal Antibodies “mabs”
-PCSK9 inhibitors ?

A

evolocumab (Repatha)

40
Q

how does evolocumab (Repatha)fxn?

A

Monoclonal Antibodies “mabs”
-PCSK9 inhibitors

  • -binds to PCSK9 which blocks PCSK9 binding to LDL receptors.
  • This increases LDL receptors, allowing LDL to bind to the receptors and be removed from the blood
41
Q

This drug is used to treat familial hypercholesterolemia or Atherosclerotic heart problems who maxed out on statins.

A

Monoclonal Antibodies “mabs”
-PCSK9 inhibitors

Prototype: evolocumab (Repatha)

42
Q

What is the route for evolocumab (Repatha)

A

Monoclonal Antibodies “mabs”
-PCSK9 inhibitors

Administered SQ , $450/month

43
Q

Side effects of evolocumab (Repatha)

A

Monoclonal Antibodies “mabs”
-PCSK9 inhibitors

injection site reactions, vasculitis, rash, urticaria. Antibody production can occur.

44
Q

only lipid lowering drug that is subq?

A

Monoclonal Antibodies “mabs”
-PCSK9 inhibitors

Prototype: evolocumab (Repatha)

45
Q

3 other agents for lowering cholesterol

A

-Fish Oil
-Plant Sterols and Sterol Esters
Benecol and Promise brands
-Cholestin
=made from rice fermented with red yeast

46
Q

this cholesterol lowering agent is made from rice fermented with red yeast

A

Cholestin

47
Q

List the 5 categories of lipid lowering drugs?

A
  1. HMG-CoA Reductase Inhibitors aka “Statins”
  2. Bile-Acid Sequestrants
  3. Cholesterol Absorption Inhibitor
  4. Fibric Acid Derivatives (Fibrates)
  5. Monoclonal Antibodies “mabs”
-PCSK9 inhibitors

Kol- Pharm 323 Spring (41 decks)

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