Cholesterol and Triglyceride Drugs

Question 1

Statins

Answer 1

Hypercholesteremia, primary and secondary prevention of CV events, CAD
Most effective drugs for lowering LDL and total cholesterol. Can also raise HDL
CONTRA: Active liver dz, pregnant, breast feeding, unexplained/elevated liver enzymes
TAKE AT NIGHT because endogenous cholesterol synthesis increases during the night
ADR: myopathies/rhabdomyolysis, hepatotoxicity, cataracts
Require adjustments

Question 2

Bile Acid Sequestrants

Answer 2

Hyperlipidemia
Reduce LDL levels, add on therapy to statins or in pts who can’t take statins
CONTRA: Routes: Colesevelam - oral tabs are most preferred. Cholestyramine - oral powder. Colestipol - Colestid
ADR: constipation

Question 3

Ezetimibe

Answer 3

Hypercholersterolemia, hyperlipidemia
Inhibits cholesterol absorption
CONTRA: use with statins when pregnant, breastfeeding, or active liver dz
Not recommended in liver impairment

Question 4

Fibrates

Answer 4

Hypertriglyceridemia
Most effective TG reducers, only raise HDL
PPA R alpha agonist: accelerates VLDL clearance and reduce levels of TG
ADR: GI
Gemfibrozil, Fenofibrate and Fenofibric acid
Drug specific adjustments

Question 5

PCSK9 Inhibitors

Answer 5

Hypercholesterolemia, lipidemia, and secondary prevention of CV events
Increases number of LDL receptors to decrease circulating LDL levels
ADR: injection site rxn

Question 6

Don’t mix

Answer 6

Lovastatin, Simvastatin, or Lipitor (avastatin)

Question 7

High intensity
Moderate
Low

Answer 7

Atorva 80 and Rosuva 40
Atorva 10, Rosuva 10, Simva 20-40 and Prava 40, Lova 40, Fluva 40
Simva 10 and Prava 10-20, Lova 20, Fluva 20-40