Dislipidemia drugs

Question 1

Atorvastatin

Answer 1

Statin;
1st line tx to reduced LDL levels;
Must be used post MI or gov’t won’t pay for hospital visit;
NO grapefruit juice (inhibits CYP3A4);
Limits production of cholesterol by increasing LDL receptors on liver –> more LDL taken out of blood;
FDA warning: myopathy –> rhabdomyolsis, memory loss/confusion, increased blood glucose;
Elevated liver enzymes/liver toxicity

Question 2

Fenofibrate

Answer 2

Fibrate; 
To reduce triglycerides (fat in blood); 
NO w/other cholesterol meds (statins); 
Binds to PPARa --> changes in gene expression in liver and muscles --> decreased triglycerides;
Elevated liver enzymes/liver toxicity

Question 3

Cholestyramine

Answer 3

Bile acid sequestrate (powder); 
Add on to statin to help lower LDL; 
Take other drugs 1 hr before/4-6 hrs after (to avoid interaction); 
Binds bile acids in gut --> eliminated; 
Constipation; 
Heartburn, nausea, belching, bloating

Question 4

Nicotinic acid (Vit B3)

Answer 4

Niacin/Vit B 3;
Works on all 3 types of cholesterol (decreases LD and triglycerides, increases HDL);
MOA not 100% know;
Flushing/red face common;
Increased uric acid levels (not for ppl w/gout)

Question 5

Ezetimibe

Answer 5

Cholesterol absorption inhibitor;
Add on to statin to help lower LDL;
Helps sm intestine and liver absorb more cholesterol from circulation;
Minimal AEs

Question 6

Evolocumab

Answer 6

PCSK-9 inhibitors;
Newest drug on market;
Changes how liver works: inhibits PCSK-9 enzyme –> increased LDL receptors on liver (more LDL uptake);
PCSK-9 gene mutations

Question 7

Garlic

Answer 7

Herbal;
Lipid reducer, HTN med, antiplatelet;
Herbs that begin w/”g” tend to have bleeding risks;
Worsens bleeding when taken w/NSAIDs or Warfarin;
Gas

Question 8

Omega-3 fatty acids

Answer 8

Herbals;
Fish oil and flax products;
Increase bleeding time (bc inhibits platelet function)