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CVM > Drugs for lipid disorders > Flashcards

Drugs for lipid disorders Flashcards

1
Q

the 2 fibrates dicussed are

A

gemfibrozil and fenofibrate

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2
Q

most potent statins

A

Atorvastatin and rosuvastatin are equal then simvastatin

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3
Q

what class of drugs predominately decreases VLDL

A

Fibrates

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4
Q

Adverse effects on muscle of statins?

A
  • CK increase (high level of physical activity)
  • Rhabdo –>renal injury and myoglobinuria
  • myopathy
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5
Q

antisense oligonucleotide that targets apolipoprotein B-100 and used to treat homozygous familial hypercholesterolemia

A

Mipomersen

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6
Q

Due to the risk of developing gallstones, Fibrates should be used with caution in what individuals?

A

those with biliary tract disease or in those at high risk (women, obese pts, native americans)

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7
Q

Which statin is NOT metabolized by CYP450s

A

pravastatin and pitavastatin

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8
Q

drug interatction for fibrates?

A

coumadin and indanedione anticoagulants

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9
Q

What patients should you use bile acid resins cautiously

A

diverticulitis, preexisting bowel disease, or cholestatis

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10
Q

What agents that inhibit CYP450 should be avoided with statins unless its pravastatin and pitavastatin

A
  • phenytoin

- griseofulvin

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11
Q

Ligand for PPAR-alpha

A

Fibrates

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12
Q

Expression of what is increased when fibrates bind to PPARalpha

A

lipoprotein lipase which then causes decreased concentration of triglycerides

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13
Q

Treatment of homozygous familial hypercholesterolemia that binds to MTP

A

lomitapide (SUPER EXPENSIVE)

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14
Q

What class of drugs are useful in treating hypertriglyceridemia that results from treatment with viral protease inhibitors?

A

fibrates

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15
Q

Ezetimibe inhibits cholesterol absorption through what?

A

NPC1L1

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16
Q

intense cutaneous flush accompanied by an uncomfortable feeling of warmth

A

Niacin

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17
Q

Statins that are inactive prodrugs that must be hyrolyzed in GI to activate

A

Lovastatin and simvastatin

18
Q

Acts by inhibiting lipolysis of triglycerides in adipose tissue which reduces free fatty acids –>liver makes less VLDL–>lower LDL

A

Niacin

19
Q

contraindications and cautious use for niacin

A
  • Contraindication in hepatic disease or active peptic ulcer

- caution with DM –>causes insulin resistance and hyperglycemia

20
Q

When are statins not recommended but not absolute contraindication

A

liver disease or skeletal muscle myopathy

21
Q

What is the least potent statin?

A

fluvastatin

22
Q

Adverse effects on liver of statins?

A

increase in aminotransferase (liver disease or alcohol use)

23
Q

Which statins have an extraordinarily long half life of 14 and 19 hours as opposed to others of around 1-3

A
  • Atorvastatin (14)

- Rosuvastatin (19)

24
Q

What time of day should statins be given?

A

in evening because cholesterol is synthesized at night unless you use longer acting one like Atorvastatin or Rosuvastatin

25
Q

Agents that are totally excreted in feces?

A

bile acid sequestrants (resins)

26
Q

When should fibrates be taken?

A

With a meal. well absorbed

27
Q

Contraindication of statins

A

pregnancy or breast feeding

28
Q

What can be used to relieve pruritus in patients who have bile salt accumulation

A

Bile acid resins

29
Q

which fibrate has short (1.5 hr) half life?

Long (20)?

A

Gemifibrozil

Fenofibrate

30
Q

most effective agent for increasing HDL

A

niacin (vitamin B3)

31
Q

Fibrate that should not be used because it is associated with cholangiocarcinoma and other GI cancers

A

clofibrate

32
Q

what is the only lipid-lowering agent that reduces lipoprotein a

A

Niacin

33
Q

What can mitigate the flushing associted with Niacin use (prostaglandin mediated)

A

Aspirin

34
Q

What drug reduces fibrinogen levels and increases tissue plasminogen activator levels which reduces endothelial dysfunction

A

Niacin

35
Q

other adverse effects of niacin other than flushing

A
  • pruritus rashes, dry skin or mucous membranes, and acanthosis nigricans
  • hepatotoxicity (used extended release)
36
Q

Fibrates should be avoided in patients with what?

A

hepatic or renal dysfunction

37
Q

Which statin is almost completely absorbed?

A

fluvastatin

38
Q

When would you use bile acid resins in monotherapy or with niacin?

A

type IIa or type IIb hyperlipidemia

39
Q

what are the 3 Bile acid sequestrants (resins?

A
  • colestipol
  • cholestyramine
  • colesevelam
40
Q

what toxicity can bile acid resins be used to treat

A

digitalis toxicity

41
Q

When a patient with insulin resistance is given niacin, what can be seen due to elevated insulin levels

A

acanthosis nigricans

42
Q

What should be the recommendation on when to take other drugs that a patient is taking along with Bile acid resins?

A

1 hours before or 2 hours after

CVM (6 decks)

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