Drugs for Lipid Disorders

Question 1

What is the mechanism of nicotinic acid?

Answer 1

inhibits lipolysis in adipose tissue, decreases hepatic TAGs synthesis and raises HDL levels.

Question 2

What is nicotinic acid used to treat?

Answer 2

hyperlipidemias with increased VLDL and LDL, though not usually used in monotherapy

Question 3

What are side effects of nicotinic acid?

Answer 3

intense cutaneous flush and pruritis, nausea and abdominal pain so take with meals, glucose intolerance, mylagia, rhabdomyalysis, precipitates gout

Question 4

What are the fibric acid derivatives?

Answer 4

Clofibrate, Fenofibrate, Gemfibrozil

Question 5

What is the mechanism of Fibric acid derivatives?

Answer 5

stimulates lipoprotein lipase which increases clearance of TAGs, raises HDL, and increase fecal excretion of cholesterol

Question 6

What are the fibric acid derivatives used to treat?

Answer 6

Type III hyperlipidemia with elevated TAGs, other familial hyperlipidemias that have poor response to most tx

Question 7

What are side effects of Fibric acid derivatives>

Answer 7

clolelithisis, clofibrate induces malignancies, do not use in pregnant/nursing women, interacts with warfarin

Question 8

What are the bile acid sequestrants?

Answer 8

Cholestyramine, Cholestipol, Colesevelam

Question 9

What is the mechanism of the bile acid sequestrants?

Answer 9

bind negatively charged bile acids in the small intestine, increaseing their fecal excretion

Question 10

What do bile acid sequestrants treat?

Answer 10

hyperlipidemias, bile acid-induced pruritis in patients with biliary obstruction

Question 11

What are adverse effects of Bile Sequestrants?

Answer 11

Fart fart fart fart, impaired absorption of vitamines DEKA, drug interactions with warfarin, aspirins, statins

Question 12

What are the HMG-CoA reductase inhibitors?

Answer 12

STATINS!

Question 13

What is the mechanism for statins?

Answer 13

inhibit HMG-CoA reductase, reducing cholesterol synthesis, reduce intracellular cholesterol levels, increase LDL receptors thus reducing plasma levels, anti-thrombotic, anti-osteoporetic, increases HDL

Question 14

What are statins used to treat?

Answer 14

Hyperlipidemias, reduced benefit with familial hypercholesterolemia

Question 15

What are drug interactions of statins?

Answer 15

grapefruit juice, ketoconazol, cyclosporin, coumadin

Question 16

What are adverse effects of statins

Answer 16

liver dysfunction, teratogenic, Monitor CK though rhabdomyolysis is rare

Question 17

What is mechanism of Exetimibe?

Answer 17

inhibits intestinal absorption of cholesterol by inhibiting transporters. Can be combined with statins

Question 18

What are therapeutic uses of Exetimibe?

Answer 18

primary hypercholesterolemia, homozygous familial hypercholesterolemia, homozygous sitosterolemia

Question 19

What are AE of ezetimibe

Answer 19

diarrhea, back pain, sinusitis, arthralgia, abd pain

Question 20

What are common combination therapies for lipid disorder tx?

Answer 20

niacin plus cholestyramine
niacine plus gemfibrozil
Niacin plus lovastatin
resin plus statin
Exetimibe plus statin

Question 21

What lipid drugs should NOT be combined with Statins?

Answer 21

Gemfribrozil, Clofibrate

Question 22

What is the mechanism of omega 3 fatty acids in fish oils?

Answer 22

eicoapentaenoic acid inhibits VLDL synthesis

Question 23

What is function of Vit B6 + B12 and folic acid in lipid tx

Answer 23

reduce homocysteine to reduce inflammatory response

Question 24

What is red yeast rice used for

Answer 24

lower LDL, no serious side effects