CV & Renal: Hyperlipidemia Drugs

Question 1

Which drug?

• ↑ LDL Receptor Expression
• ↓ Plasma LDL by 20-40%
• DOC to ↓LDL

Answer 1

Statins

Question 2

This hyperlipidemia medication has the following effects:

↓LDL
↓ TGs
↑ HDL

Other cardioprotective effects:

↓ CRP, Lipoprotein Oxidation, Platelet Aggregation
↑ Plaque Stability

Answer 2

Statins

Question 3

What are 2 contraindications/precautions for statin use?

Answer 3

Pregnancy

Active Liver Disease

Question 4

What increases statin concentration?

Answer 4

P450 inhibitors increase statin concentration

Question 5

Which drug inhibits statin metabolism?

Answer 5

Gemfibrozil

Question 6

Describe the dosing of atorvastatin for high-risk ASCVD patients…

Answer 6

high intensity dose

Question 7

Which two statins are prodrugs that must be hydrolyzed to active form and therefore should be taken in the evening

Answer 7

lovastatin and simvastatin

Question 8

Which hyperlipidemia drug has the following characteristics?

Effective at lowering LDL
LDL ↓ by 20%
safe in pregnancy

Answer 8

Bile acid sequestrants

Question 9

Which drug is a bile acid sequestrant?

Answer 9

cholestyramine

Question 10

Which drug impairs the absorption of…

Digitalis
Thiazides
Statins
Tetracycline
Thyroxine
ASA

Answer 10

Cholestyramine

Question 11

Which hyperlipidemia drug has the following adverse effects?

Constipation & Bloating

Steatorrhea

Rare hypoprothrombinemia w/ vit. K malabsorption

Answer 11

cholestyramine

Question 12

This drug is the most effective agent at increasing HDL

Answer 12

Niacin

Question 13

What can moderate the cutaneous vasodilation induced by niacin?

Answer 13

ASA

Question 14

the following are mild adverse effects of…

Cutaneous Vasodilation

NV, GI

↑ LFTs → Impaired glucose tolerance

Rare: Hepatotoxicity

Answer 14

niacin

Question 15

describe the size of dose of niacin

Answer 15

gram range dosage

Question 16

This drug is useful in hypertriglyceridemia, and can reduce TGs by 40-50%

Answer 16

Gemfibrozil (fibrates)

Question 17

Which drug has the following mechanism?

↑ LPL Receptors and Genes involved in fatty acid oxidation

Binds PPAR-Alpha Ligand, a nuclear receptor

Answer 17

Gemfibrozil

Question 18

What are two unique adverse effects of gemfibrozil?

Answer 18

risk of cholelithiasis

increased LDL in combined hyperlipidemia

Question 19

does cholestyramine have any effect in homozygous familial hypercholesterolemia?

Answer 19

no

Question 20

Which drug blocks intestinal cholesterol absorption?

Answer 20

ezetimibe

Question 21

Ezetimibe has what three effects?

Answer 21

Moderate ↓LDL (18%)

Synergistic in-combo with statin

No known adverse effects

Question 22

Is there evidence that shows ezetimibe reduces CV mortality?

Answer 22

no

Question 23

Which drugs are PCSK9 inhibitors?

Answer 23

Alirocumab (Praluent), Evolocuman (Repatha)

Question 24

What are three features of PCSK9 inhibitors?

Answer 24

↓ Plasma LDL

No determined effect on mortality

No adverse effects

Question 25

describe the route of administration of PCSK9 inhibitors…

Answer 25

monthly subcutaneous injection