Cholesterol Pharm

Question 1

HMG CoA

Answer 1

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

Question 2

ACAT

Answer 2

esterifies cholesterol. acyl-coenzyme A cholesterol acyltransferase

Question 3

Lipoprotein lipase

Answer 3

removes triglycerides from chylomicrons and VLDL

Question 4

what lipoproteins have most triglycerides

Answer 4

Chylomicrons and VLDL. the rest have more cholesterol esters

Question 5

LCAT

Answer 5

Lecithin cholesterol acyl transferase. HDL->IDL

Question 6

what lipoproteins have the most cholesterol?

Answer 6

LDL, HDL

Question 7

what happens to LDL in the liver

Answer 7

converted to bile acids and secreted into the intestines

Question 8

what happens to nonhepatic LDL

Answer 8

used for hormone production, cell membrane synthesis, or stored

Question 9

what is the function of HDL?

Answer 9

procures triglyceride depleted chylomicron and VLDL remnants and acquires free cholesterol

Question 10

240=high

Answer 10

Guidelines for total cholesterol

Question 11

what is the ranges for LDL cholesterol

Answer 11

160 =high

Question 12

what is desireable for HDL levels?

Answer 12

> 60

Question 13

risk factors for hypercholesterolemia

Answer 13

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

Question 14

Omega-3

Answer 14

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

Question 15

synthetic form of Omega-3

Answer 15

Lovaza

Question 16

what drug prevents intestinal absorption of cholesterol?

Answer 16

Ezetimibe

Question 17

Cholesterol is made into 4 bile acids through which pathway

Answer 17

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

Question 18

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

Answer 18

True

Question 19

Bile acid sequestrants

Answer 19

Cholestyramine, Colesevelam, Colestipol?,

Question 20

What effects does bile acid sequestrants have

Answer 20

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

Question 21

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

Answer 21

False: vitamin K malabsorption

Question 22

What does Niacin do?

Answer 22

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

Question 23

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

Answer 23

true

Question 24

Statin actions

Answer 24

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

Question 25

What statins are metabolized by CYP3A4

Answer 25

Lovastatin, simvastatin, atorvastatin

Question 26

What statins are metabolized by CYP2C9

Answer 26

Fluvastatin, rosuvastatin

Question 27

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

Answer 27

Mevastatin, Lovastatin, Simvastatin

Question 28

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

Answer 28

niacin and cyclosporin

Question 29

CYP 3 inducers

Answer 29

BARBITUATES!! cause decreased statin levels

Question 30

cyclosporine and fibrates taken with statins will

Answer 30

increase statin levels (cYP3A4 inhibitors.

Question 31

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

Answer 31

Plasma levels will increase due to CYP3A4 inhibition

Question 32

Name two Fibrates

Answer 32

Gemfibrozil, clofibrate

Question 33

How do fibrates function?

Answer 33

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

Question 34

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

Answer 34

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

Question 35

whats a major risk of fibric acids

Answer 35

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

Question 36

What drug impairs intestinal absorption of cholesterol by inhibiting NPC1L1

Answer 36

Ezetimibe. gets absorbed, excreted into bile and feces.

Question 37

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

Answer 37

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

Question 38

Treatment of HIgh LDL

Answer 38

sequestratnts and either niacin or statin

Question 39

High LDL and triglycerides

Answer 39

Niacin or gemfibrozil, and sequestrant or statin

Question 40

treatment of high triglycerides

Answer 40

gemfibrozil or niacin (nicotinic acid)

Question 41

Low HDL treatment

Answer 41

niacin(nicotinic acid) or gemfibrozil