Cholesterol Pharmacology

Question 1

What do statins inhibit?

Answer 1

HMG-CoA reductase

Question 2

Describe the mechanism of action of statins

Answer 2

Inhibit cholesterol synthesis in liver (due to inhibition of HMG-CoA reductase)

Question 3

What are the adverse drug reactions of statins?

Answer 3

Myopathy, increased transaminase levels, GI effects, arthralgias and headaches

Question 4

What are some secondary benefits of statins?

Answer 4

Anti-inflammatory, plaque reduction, imroved endothelial cell function, reduced thrombotic risk

Question 5

When are statins used?

Answer 5

Prevention of CVD for adults who have an increased risk

Given after cardiac events

Familial hypercholesterolaemia

Question 6

What do fibrates do?

Answer 6

Reduce triglyceride production and increase HDL

SOME reduction in LDL

Question 7

What are the side effects of fibrates?

Answer 7

GI upset, cholelithiasis, myositis, abnormal LFTs

Question 8

What does nicotinic acid do?

Answer 8

Reduces VLDL and increases HDl

Lipid lowering effect by inhibition of lipoprotein (a) synthesis

Question 9

What are the adverse effects of nicotinic acid?

Answer 9

Flushing, itching, headache, hepatotoxicity, activation of peptic ulcer, hyperglycaemia

Question 10

What does ezetimibe do?

Answer 10

Selectively inhibits intestinal cholesterol absorption - decreased intestinal delivery of cholesterol to the liver

Question 11

What are the adverse drug reactions of ezetimibe?

Answer 11

Headache, abdominal pain and diarrhoea

Question 12

What are fibrates plus statins associated with an increased risk of?

Answer 12

Myopathy and rhabdomyolysis

Question 13

What is the target cholesterol level?

Answer 13

Under 5 mmol/L