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MOHD 3 Exam 2 > Cholesterol Pharm > Flashcards

Cholesterol Pharm Flashcards

1
Q

HMG CoA

A

converted to mevalonic acid in cholesterol synthesis pathway by HMG CoA reductase

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2
Q

ACAT

A

esterifies cholesterol. acyl-coenzyme A cholesterol acyltransferase

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3
Q

Lipoprotein lipase

A

removes triglycerides from chylomicrons and VLDL

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4
Q

what lipoproteins have most triglycerides

A

Chylomicrons and VLDL. the rest have more cholesterol esters

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5
Q

LCAT

A

Lecithin cholesterol acyl transferase. HDL->IDL

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6
Q

what lipoproteins have the most cholesterol?

A

LDL, HDL

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7
Q

what happens to LDL in the liver

A

converted to bile acids and secreted into the intestines

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8
Q

what happens to nonhepatic LDL

A

used for hormone production, cell membrane synthesis, or stored

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9
Q

what is the function of HDL?

A

procures triglyceride depleted chylomicron and VLDL remnants and acquires free cholesterol

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10
Q

240=high

A

Guidelines for total cholesterol

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11
Q

what is the ranges for LDL cholesterol

A

160 =high

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12
Q

what is desireable for HDL levels?

A

> 60

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13
Q

risk factors for hypercholesterolemia

A

male, family history of coronary heart diease, smoking, hypertension, low HDL, diabetes, obesity

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14
Q

Omega-3

A

activates PPAR-alpha which decreases triglycerides, but may increase LDL

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15
Q

synthetic form of Omega-3

A

Lovaza

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16
Q

what drug prevents intestinal absorption of cholesterol?

A

Ezetimibe

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17
Q

Cholesterol is made into 4 bile acids through which pathway

A

CYP7A1. cholic acid, deoxycholic acid, chenodeoxycholic acid, lithocholic acid

18
Q

True or false: 95% of bile is reabsorbed in intestines and the liver uses same amount of cholesterol for synthesis as is excreted

A

True

19
Q

Bile acid sequestrants

A

Cholestyramine, Colesevelam, Colestipol?,

20
Q

What effects does bile acid sequestrants have

A

increase uptake of LDL from upregulaiton of LDL receptors. increase hepatic production of vldl and increased triglycerides

21
Q

True or false: side effects of sequestrants include dyspepsia, constipation, diarrhea and malabsorption of vitamin A

A

False: vitamin K malabsorption

22
Q

What does Niacin do?

A

inhibits VLDL secretion, ultimately lowering LDL production. Decreases triglycerides more than cholesterol

23
Q

True or false: long-term niacin treatment increases insulin resistance

A

true

24
Q

Statin actions

A

HMG CoA reductase inhibitors, block production of cholesterol. also causes LDL receptor increase.

25
Q

What statins are metabolized by CYP3A4

A

Lovastatin, simvastatin, atorvastatin

26
Q

What statins are metabolized by CYP2C9

A

Fluvastatin, rosuvastatin

27
Q

which of the following are prodrugs? Lovastatin, pravastatin, fluvastatin, simvastatin, mevastatin

A

Mevastatin, Lovastatin, Simvastatin

28
Q

statins can cause myopathy, that is worse when taken with…

A

niacin and cyclosporin

29
Q

CYP 3 inducers

A

BARBITUATES!! cause decreased statin levels

30
Q

cyclosporine and fibrates taken with statins will

A

increase statin levels (cYP3A4 inhibitors.

31
Q

What happens to someone on lovastatin, simvastatin, or atorvastatin who drinks 1 L of grapefruit juice a day?

A

Plasma levels will increase due to CYP3A4 inhibition

32
Q

Name two Fibrates

A

Gemfibrozil, clofibrate

33
Q

How do fibrates function?

A

ligands for PPARalpha - upregulates lipoprotein lipase, apo A-I and apo A-II

34
Q

Fibric acids: which is false. modest decrease of LDL, lowers triglycerides, lowers HDL, Used for treateing hypertriglyceridemias

A

Fibric acids raise HDL cholesterol, helped by apo A1 and A2. Rest are true

35
Q

whats a major risk of fibric acids

A

myopathy, especially when taken with statins. gemfibrozil increases conc. of statins by partially inhibiting glucuronidation of statin acid byproduct

36
Q

What drug impairs intestinal absorption of cholesterol by inhibiting NPC1L1

A

Ezetimibe. gets absorbed, excreted into bile and feces.

37
Q

What is increased or lowered in sequestrants, nicotinic acid, statins, fibrates, ezetimibe.

A 
sequestrants: decr. LDl
Niacin: decr LDL, incr HDL, decr triglycerides.
Statins:decrease LDL.
Fibrates: lower triglycerides
Ezetimide: decr LDL
Omega 3: lowers triglycerides
38
Q

Treatment of HIgh LDL

A

sequestratnts and either niacin or statin

39
Q

High LDL and triglycerides

A

Niacin or gemfibrozil, and sequestrant or statin

40
Q

treatment of high triglycerides

A

gemfibrozil or niacin (nicotinic acid)

41
Q

Low HDL treatment

A

niacin(nicotinic acid) or gemfibrozil

MOHD 3 Exam 2 (7 decks)

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