Drugs to Treat Dyslipidemias

Question 1

MOA of resins (2):

Answer 1

• Bind bile acids in small intestine

- Increase conversion of hepatic cholesterol to bile acids

Question 2

Resins can be used at age:

Answer 2

> 6 years old

Question 3

ADRs of resins (3):

Answer 3

• Bloating
• Constipation
• Abdominal pain

Question 4

MOA of statins:

Answer 4

Competitive inhibitor of rate limiting step in endogenous cholesterol biosynthesis (HMG CoA Reductase)

Question 5

Statins - Site of action:

Answer 5

Liver

Question 6

Statins approved to lower cholesterol AND triglycerides (2):

Answer 6

• Atorvastatin

- Rosuvastatin

Question 7

ADRs of statins (2):

Answer 7

• Elevate ALT/AST

- Increase creatine phosphokinase (CPK) - myopathy

Question 8

Contraindications of statins (3):

Answer 8

• Pregnancy
• Nursing mothers
• Acute liver disease

Question 9

Age of statin use (2):

Answer 9

• Pravastatin: 8 years old

- All others: 10 years old

Question 10

Statins that should be taken at night (3):

Answer 10

• Fluvastatin
• Lovastatin
• Simvastatin

Question 11

Statins whose bioavailability is lowered by food (2):

Answer 11

• Pravastatin

- Pitavastatin

Question 12

Statins effected by CYP3A4 inhibitors/grapefruit juice (3):

Answer 12

• Atorvastatin
• Lovastatin
• Simvastatin

Question 13

Ezetimibe MOA (3):

Answer 13

• Inhibits cholesterol absorption at enterocytes
• Inhibits NPC1L1 transporter protein
• Targets dietary cholesterol

Question 14

PCSK9 inhibitors (2):

Answer 14

• Alirocumab

- Evolocumab

Question 15

PCSK9 inhibitor administration regimine:

Answer 15

Every 2 weeks SQ

Question 16

Drugs to lower triglycerides (2):

Answer 16

• Fibrates

- Nicotinic acid

Question 17

Fibrates bind to:

Answer 17

PPARalpha

Question 18

MOA of fibrates (3):

Answer 18

• PPARalpha stimulates fatty acid oxidation
• Reduces apoCIII expression resulting in increased LPL activity
• Decrease hepatic production of VLDL

Question 19

Actions of fibrates (3):

Answer 19

• Increase LPL
• Increase HDL
• Decrease TG

Question 20

ADRs of fibrates (2):

Answer 20

• Increased risk of gallstones (clofibrate)

- Increased risk of myopathy when combined with statins

Question 21

Contraindications of fibrates (3):

Answer 21

• Liver dysfunction
• Renal disease
• Preexisting gallbladder disease

Question 22

ADRs/precautions of nicotinic acid (5):

Answer 22

• Itching and flushing
• Elevate ALT/AST
• Monitor creatine kinase when combined with statins
• Precipitate peptic ulcer
• May cause hyperuricemia and glucose intolerance