cholesterol meds

Question 1

3 classes that mainly lower TG and increase HDL-C

Answer 1

• fibrates
• fish oils
• niacin

Question 2

HMG-CoA reductase inhibition→ reduce intrahepatic cholesterol pool→ upregulation of hepatic LDL receptors & removal of LDL from blood

Answer 2

HMG-CoA inhibitor

Question 3

which class has pleiotropic effects

Answer 3

HMG-CoA inhibitors

Question 4

contraindications of liver dz, pregnancy & combo w/ fibrates

Answer 4

statins

Question 5

2 main SE of myopathy/myalgia and abnormal LFTs

Answer 5

statins

Question 6

best for TG > 400-500 mg/dl to prevent pancreatitits

Answer 6

fibrates

Question 7

activate LPL and reduce apo CIII (LPL inhibitor)

Answer 7

fibrates MOA

Question 8

2 major effects of fibrates

Answer 8

lower TG & LDL
increase HDL

Question 9

contras of liver & severe kidney dz, gallstones, pregnancy

Answer 9

fibrates

Question 10

SE of gallstones, increased creatinine secr., myalgia/myopathy, GI sx, DVT/PE

Answer 10

SE of fibrates

Question 11

what class do you use for 2-3 mo before assessing for efficacy

Answer 11

fibrates

Question 12

which class does Compensatory ↑HMG CoA limit effectiveness making it best used w/ statins?

Answer 12

cholesterol absorption inhibitors (bile acid resins & ezetimibe)

Question 13

major effect of cholesterol absorption inhibitors

Answer 13

lower LDL

Question 14

med that blocks bile salt absorption in terminal ileum→ reduce intrahepatic cholesterol pool → upregulation of hepatic LDL receptors + LDL removal

Answer 14

bile acid resin

Question 15

why arent bile acid resins used much?

Answer 15

tastes gross & makes you super constipated

Question 16

has contraindications of Elevated TG (esp >200), complex med. regimen and bowel or biliary obstruction

Answer 16

bile acid resins

Question 17

has dose-dependent SEs of Discomfort & constipation
Less drug absorp., Less fat soluble vitamin absorp.

Answer 17

bile acid resins

Question 18

MOA of blocking absorption of cholesterol in s. Intestine by inhibiting the NPC1L1 protein→ reduce intrahepatic cholesterol pool→ increase hepatic LDL receptors + LDL removal

Answer 18

Ezetimibe

Question 19

name the sole med that has severe liver dz as the only CI

Answer 19

Ezetimibe

Question 20

major effect of niacin (2)

Answer 20

lower TG, increase HDL
also lowers LDL

Question 21

MOA of niacin vs fish oil (3)

Answer 21

Both
* ↓ VLDL production & TG
* ↓ lipolysis in adipocytes
Niacin only:
* ↓ Apo A-1 catabolism, but ↑chol removal from HDL

Question 22

Most potent med to increase HDL levels

Answer 22

niacin

Question 23

which med has CI of Liver dz, gout, uncontrolled T2DM, pregnancy

Answer 23

niacin

Question 24

which 3 meds/classes has pregnancy as CI?

Answer 24

• statins
• fibrates
• niacin

Question 25

which med has ADR of Increased prostaglandins causing flushing & itching (less when aspirin taken 30 mins before), belly pain, ulcers, GI sx (less w/ meals), Insulin resistance/hyperglycemia, Hepatotoxicity, Hyperuricemia– Gout, myalgia/myopathy (esp w. statin)

Answer 25

niacin

Question 26

which med has these effects:
* Lower TG; increase HDL
* non lipid effects of plts, membrane stabilization

Answer 26

fish oil

Question 27

which med has C/I of Eructation, flatulence, belly pain, bruising/bleeding, A. fib. ?

Answer 27

fish oil

Question 28

which class has MOA of preventing LDL receptor degradation + preserves recycling to hepatocyte surface → ↑receptor density→ ↑LDL clearance

Answer 28

PCSK9 inhibitors

Question 29

which class has injection site rxn as sole ADR?

Answer 29

PCSK9 inhibitors

Question 30

which 4 HTN meds are used in pregnancy

Answer 30

• labtelol
• hydralazine
  * nifedipine
• methyldopa

Question 31

1 complaint of cholesterol lowering drugs amongst patient

Answer 31

GI sx

Question 32

3 meds that cause myopathy

Answer 32

• fibrates
• niacin
• statins