Drugs

Question 1

What are examples of statins? used for?

Answer 1

Lovastatin, simvastatin, atorvastatin, rosuvastatin (most recommended) - lowering BP

Question 2

What are examples of bile acid sequesterants? used for?

Answer 2

cholestyramine and colestipol - lowering BP

Question 3

Statin MOA?

Answer 3

Inhibits HMG-CoA – which prevents the conversion of AcCoA to melvonic acid – key step in cholesterol synthesis – liver increases LDL receptors decreasing serum LDL

Question 4

What is the bile acid sequesterant MOA?

Answer 4

Anion exchange binds negatively charged bile acid in small intestine and forms complex because they are insoluble in water allowing for excretion in feces –> compensatory LDL receptor increase causing serum LDL to lower

Question 5

What drug classes are used to treat hyperlipedemia?

Answer 5

HMG-CoA reductase inhibitors (statin)
Bile acid sequesterant resins
Nicotinic acid
Fibric acid

Question 6

What drug reduces BP by inhibiting VLDL secretion – and increases HDL levels?

Answer 6

Nicotinic acid (niacin)

Question 7

What is an example of a fibric acid derivative? What is it used for?

Answer 7

Gemfibrozil, used to lower BP

Question 8

What is the MOA of gemfibrozil?

Answer 8

Inhibits fatty acid synthesis – enhanced LPL hydrolysis leading to decreased TGs – stimulates ApoA1 to increase HDL and decrease LDL

Question 9

What are the side effects of statins?

Answer 9

Increased liver enzyme, rhabdomyolysis, myopathy, renal failure, trasaminase hepatitis – very serious

Question 10

What are the side effects of niacin?

Answer 10

Flushing, hyperglycemia, hyperuricemia or gout, upper GI

Question 11

What are the side effects of fibric acids?

Answer 11

Dyspepsia (indegestion), gallstones, myopathy

Question 12

What are the side effects of bile acid sequesterant?

Answer 12

GI distress, constipation, decreased absorption of other drugs, non-compliance

Question 13

What drug class and drug prevents cholesterol absorption at brush border?

Answer 13

Transport inhibitor - zetia (ezetimibe)

Question 14

Which drug is a good alternative to statins and why? or can be combined with statins (what is the combined name?

Answer 14

Zetia b/c no myopathy – simvastatin + zetia = vytorin

Question 15

What drug class and name uses monoclonal antibodies to control BP?

Answer 15

Proprotein convertase subtilisn/kexin type 9 (PSCK9) – Alirocumab (praluent)

Question 16

What is the MOA of Alirocumab?

Answer 16

Binds PCSK9 to prevent LDL receptor recyling during inactivation and destruction by lysosomes – allows more LDL to be taken up and removed from plasma

Question 17

Treatment for Anticholinergic toxicity?

Answer 17

Physostigmine – AchE antagonist

Question 18

Treatment for cholinergic toxicity?

Answer 18

Anti-cholinergic – Atropink, pralidoxime (2-PAM), Benzos for agitation

Question 19

Treatment for adrenergic toxicity?

Answer 19

Benzos, icepack, fluids, BP management

Question 20

BB/CCB toxicity treatment?

Answer 20

No antidote

Question 21

Acetaminophen (APAP) toxicity treatment?

Answer 21

N-acetylcystine (NAC)

Question 22

Alcohol toxicity treatment?

Answer 22

Fomepizole

Question 23

What is a serotonin receptor antagonist that can reach CTZ and inhibits vomiting?

Answer 23

Ondansetron

Question 24

What is a DA antagonist that can reach CTZ and inhibits vomiting?

Answer 24

Metoclopramide

Question 25

What is an antipsychotic drug that is a DA antagonist and anti-emetic that can reach CTZ?

Answer 25

Prochlorperazine

Question 26

What are DA agonists that induce vomiting?

Answer 26

Syrup of Ipecac and Apomorphine