Drug Therapy Of Hyperlipidemia

Question 1

Mention the type if lipoproteins derived from dietary TG

Answer 1

Chtlomicrons

Question 2

VLDL is hydrolysed into …., which is hydrolysed into …..

Answer 2

IDL

LDL

Question 3

Mention the lipoprotein which removes cholesterol from tissues to be degraded in liver

Answer 3

HDL

Question 4

Mention vitamins which imrpive dyslidemia

Answer 4

Vit E & C

Question 5

Which element of management of hyperlipidemia inc HDL

Answer 5

Exercise

Question 6

Describe mechanism of action & additional effects of statins

Answer 6

Structural analogue to HMG CoA, inhibits HMG CoA reductase, thus dec cholesterol synthesisvin liver, which resukts in compensatory inc in LDL receptors which dec plasma LDL-cholesterol
Dec TG & inc HDL
Cardioprotective VD & dec atherosclerosis

Question 7

Mention therapeutic uses of statins

Answer 7

Hyoercholesterolemia

Combined hyoerlipidemia

Question 8

Mention adverse effects of statins

Answer 8

Myopathy, muscle damage & renal failure
Inc serum liver enzymes (CI in hepatic dysfunction)
Cataract
GIT disturbance

Question 9

Describe mechanism of action of cholestyramine

Answer 9

Anion exchange resins, bind bile acids and prevent absorption
Increase bile acid synthesis from cholesterol in liver
Dec intrahepatic cholesterol, inc LDL receptor and inc hepatic uptake of circukating LDL dec serum LDL-cholesterol

Question 10

Mention therapeutic uses of cholestyramine & adverse effects

Answer 10

Uses: Hypercholesterolemia esp with statins, addition of statins offsets inc cholestrol synthesis in liver with long term cholestyramine therapy.
Adverse effects: GIT disturbance, dec absorption of digoxin & warfain & fat-soluble vitamins.

Question 11

Describe mechanism of action & additional effects of fibrates

Answer 11

Agonists of PPAR-alpha receptor which inc expression of genes responsible for inc lipoprotein lipase activity, this results in cleavage of VLDL & chylomicrons, DEc serum TGs levels.
Inc LDL ckearance & inc HDL.

Question 12

Describe adverse effects of fibrates

Answer 12

GIT disturbance
Gall stones
Myopathy & muscle pain

Question 13

Describe mechanism of action of nictoinic acid

Answer 13

Potent inhibitor of lipolysis in adipose tissue which dec mobilization of FFAs to liver and dec VLDL thus LDL is dec. it also inc HDL.

Question 14

Mention therapetic uses of nictonic acid

Answer 14

Hyperlipidemia

Severe hypercholesterolemia

Question 15

Mention adverse effects of nicotinic acid

Answer 15

Cutaneous flush
GIT disturbance
Glucose intolerance
Gouty arthritis
Myopathy

Question 16

Mention action, use & adverse effects of ezetimibe

Answer 16

Inhibits intestinal cholesterol absorption
Used in hypercholesterolemia togetehr iwth diet & statins
Diarrhea, abdominal pain

Question 17

Mention safest comination and CI combination in hyperlipidemia treatmnet

Answer 17

S, bile sequestrants + nicotinic acid/statins

CI, statins + fibrates

Question 18

Mention the synegistic & the cautionsly-used combination

Answer 18

S, ezetimide +statins

C, nicotinic acid + statins

Question 19

Mention 2 drugs restricted to familial hypercholesterolemia

Answer 19

MTP inhibitors (Lomitapide)
Anti-sense inhibition if apo B 100 synthesis (Mipomersen)

Question 20

Effects of AMP kinase activation

Answer 20

Inc fatty acid oxidation , insulin sensivity, inhibit cholesterol & TG synthesis