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Alan's lecture - Pharmacology > CVS 5 > Flashcards

CVS 5 Flashcards

1
Q

Cardiovsacular disease is associated with increased LDL and decrease HDL. TRUE OR FALSE?

A

TRUE

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2
Q

Nmae the three types of Hyperlipidemia’s?

A
  • Hypercholesteridemia
  • Hypertriglyceridemia
  • Mixed hyperlipidemia
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3
Q

Lowering LDL/HDL decreases risks of athesclerosis. TRUE OR FALSE?

A

TRUE

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4
Q

List the following in increasing protein and lipid ratio (LDL,HDL,VLDL,chylomicrons?

A
  • Chylomicrons
  • VLDL
  • LDL
  • HDL
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5
Q

Hyperlipidemia can be caused by genetic compenets or by diet. TRUE OR FALSE?

A

TRUE

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6
Q

How do you manage hyperlipidemia?

A
  • stop smoking (reduces risks of coronary heart disease)
  • diet and diabetes management
  • lifestyle changes before pharmacological intervention
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7
Q

What are the two types of pharmacological intervention iwith hyperlipidemia managemnt?

A
  • Primary prevention - treatment before clinical eveidence of disease e.g if patient has had history of high cholesterol levels
  • Secondary prevention - after clinical evidence of the disease - try to signficantly reduce risks of M.I
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8
Q

statins inhibit the enzyme HMGCR. true or false?

A

TRUE

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9
Q

how many carbons does HMGCoA have?

A

6 carbons

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10
Q

Statins inhibit HMGCR enzyme. true or false?

A

true

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11
Q

the cholesterol synthesis pathway is dependent upon the amount of cholesterol in a patients body. true or false?

A

true

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12
Q

if cholesterol is high in a patients body the cholesterol synthesis pathway is turned off and vice versa through the SREBP transcription factor. true or false?

A

true

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13
Q

what are statins indicated for?

A
  • Stroke

- Coronary heart disease

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14
Q

How do statins work?

A
  • Inhibit cholesterol synthesis
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15
Q

Name a statin that is a pro-drug and is metabolised by CYP3A4?

A

Simvastatin

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16
Q

Name a statin with a half life of 14hr and is metabolised by CYP3A4?

A
  • Atorvastatin
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17
Q

What is the dominant site of action of statins?

A

The liver

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18
Q

Which statin are not metabolised by CYps?

A
  • Rosuvastatin

- Pravastatin

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19
Q

What are some ADRs of statins?

A
  • Generally well tolerated but patients are at risk of myopathy
20
Q

What are some interactions of statins?

A
  • affects drugs affecting CYP P450 enzymes
21
Q

what are bile acid binding resins indicated for?

A
  • For patients which statins on own is insufficient
22
Q

what is the mechanism of action for bile acid binding resins?

A
  • Positively charged resin binds negatively charged bile
    ↓decreased re-absorbtionbile (enterohepaticrecirc.)→↑excretion–↑bile synthesis →↓liver cholesterol →↑LDL receptor expression → ↓plasma cholesterol
23
Q

bile acid binding resin is insoluble in water. true or flase?

A

true

24
Q

bile acid binding resin decreases LDL by 30% true or false?

A

true

25
Q

Bile acid binding resin also bind vitamin A,D AND K therefore supplements of these are neccesary. TRUE OR FALSE?

A

TRUE

26
Q

What are inhibitors of cholesterol absorption indicated for?

A
  • Hypercholesteronmia

- Or with statin or if statin not good on own

27
Q

What is the mechanism of action of cholesterol absorption inhibitors?

A
  • Inhibit transport of cholesterol across intestinal brush border
28
Q

Provide a drug name for cholesterol absoprtion inhibitors?

A
  • Ezetimibe
29
Q

Cholestrol absorption inhibitors also reduce cholestrol in chylomicrons. TRUE OR FALASE?

A

TRUE

30
Q

Why do cholestrol absorption inhibitors have long half lives?

A
  • because they undergo constant enterohepatic recirculation
31
Q

What are some interactions of cholestrol absoprtion inhibtors?

A
  • They plasma concentration increases with fibrates
32
Q

How do fibrates work?

A
  • activates the PPARa transcription factor
  • which decreases triglycerides
  • Lowering LDL
33
Q

What are fibrates indicated for?

A
  • Hypercholesterimia

- Hypertriglyceridpedimia

34
Q

what are the cautins for fibrates?

A
  • They cause myotoxicity especially in patients with renal disease
35
Q

Fibrates are excreted in urine as glucorinode conjugates. TRUE OR FALSE?

A

TRUE

36
Q

What are some ADRs of fibrates?

A
  • Cause GI disturbances

- Myopathy

37
Q

How do PCSK9 inhibitors work?

A
  • They increase expression of LDL-R

- which leads to an increase in the LDL clearance

38
Q

What is nicotinic acid indicated for?

A
  • Hyperlipidemia

- Hyperglycemia

39
Q

How doe nicotinic acid work?

A
  • Increase HDL by decreasing lipolysis in adipose tissue

- Leads to decrease in VLDL, LDL and triglycerides

40
Q

Give a drug name for nicotinic acid?

A
  • Niacin
41
Q

What are some ADRs of nicotinic acid?

A
  • Can lead to diabetes

- Hyperurecemia - decrease in uric acid secretion leading to gout

42
Q

Niacin increases risk of bleeding. TRUE OR FALSE?

A

TRUE

43
Q

Omega-3-fatty acid are known to decrease triglyceride synthesis. TRUE OR FALSE?

A

TRUE

44
Q

What are two fish oil types?

A
  • EPA

- DHA

45
Q

what is necrosis?

A
  • Cell death but with leakage
46
Q

How does an atherosclerosis plaque start to build up?

A
  • LDL have a long half life and are full of cholesterol (means that they can stay for a long time)
  • They can bind to proteio glycans
  • LDL becomes oxidised
  • Get recognised by macropahses
  • Macrophageases ingest them
  • Forming - foam cells and causing necrosis
  • This grows further and starts to occlude the arteries

Alan's lecture - Pharmacology (16 decks)

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