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CPR II Exam 1 > Drugs to Treat HLD pt.2 > Flashcards

Drugs to Treat HLD pt.2 Flashcards

1
Q

What is lovastatin?

A

HMG-CoA reductase inhibitor, low med subclass, first in class

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2
Q

What is an adverse effect of fish oil?

A

Belching

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3
Q

Consumption of alcohol raises what?

A

triglyceride levels

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4
Q

What is the function of lipoproteins?

A

transport water insoluble TAG and cholesterol/cholesterol esters in the plasma

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5
Q

What is a very common adverse effect of niacin?

A

Flushing, can be diminished by taking it with food or 30min after aspirin

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6
Q

What is the percentage of LDL-C lowering seen with atorvastatin and rosuvastatin?

A

Med high

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7
Q

What is another example of a PCSK9 inhibitor?

A

Alirocumab

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8
Q

What is hypertriglyceridemia?

A

means triglyceride levels are >200; a reason to initiate or increase dose of statins if levels are >500

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9
Q

What is the leading cause of death?

A

Heart disease; risk can be estimated with online tools such as ASCVD risk estimator

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10
Q

What is a positive risk factor for atherosclerotic CVD?

A

Age

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11
Q

What is atorvastatin?

A

HMG-CoA reductase inhibitor, med high subclass, most prescribed drug in US in 2019

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12
Q

What is a general term for adverse effects that are common among drugs used to treat hypercholesterolemia and/or hypertriglyceridemia?

A

GI distress

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13
Q

What is an example of the few things that are permitted by a triglyceride lowering diet?

A

Legumes, provided no salt added and they have not been ultra processed into meat alternatives

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14
Q

What is the principal component of LDL?

A

cholesterol ester

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15
Q

What are triglycerides?

A

Main constituents of natural fats and oils; store energy; beta blockers, thiazides, loop diuretics, and bile acid sequestrants are among the agents that increase their circulating levels in plasma; a diagnostic criteria for metabolic syndrome if elevated

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16
Q

What is the borderline range for total cholesterol in adults?

A

200-239

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17
Q

New onset of DM is common in those with what?

A

risk factors for when statins are used to lower plasma cholesterol levels, similarly for niacin but doesnt appear to be associated with PCSK9 monoclonal Ab; potentially worsened by fish oils

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18
Q

Diabetes is associated with both hypercholesterolemia and what?

A

hypertriglyceridemia; its onset has been associated with the use of statins but not PCSK9 inhibitor s

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19
Q

What adverse event led to the withdrawal of the first fibrate from the market?

A

Gallstones; still associated with this class but seems to be less of a problem with gemifibrozil and fenofibrate

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20
Q

What are fibrates?

A

drug class widely used to lower plasma triglyceride levels but recent data has failed to provide evidence that they are actually lowering atherosclerotic coronary vascular disease

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21
Q

What are the effects of exercise?

A

Lack of exercise lowers HDL but not increasing it has minimal impact on LDL; it can lower plasma levels of triglycerides

22
Q

What is APOE?

A

Synthesized by liver and various other cells; it integrates into lipoproteins because of its high avidity for their phospholipid coat where it then serves as a ligand for lipoprotein remnant uptake by the liver

23
Q

Lysosomes serve as a degradation site for what?

A

LDL and PCSK9 LDL-R complex

24
Q

What is a hormonal cause of increases in LDL and triglycerides?

A

hypothyroidism

25
Q

If waist circumference is elevated it counts toward diagnosis of what?

A

metabolic syndrome

26
Q

Many people with hypercholesterolemia lack what?

A

symptoms and are unaware

27
Q

The pt needs to have a prominent role in decisions regarding what?

A

the prevention of atherosclerotic CVD

28
Q

What is the 2nd FA in fish oil?

A

Eicosapentaeinoic acid

29
Q

What is simvastatin?

A

HMG-CoA reductase inhibitor, most prescribed among the low med subclass

30
Q

What is HDL?

A

initially created as empty vessels to scavenge free cholesterol from the periphery; there are predominately protein

31
Q

What is LDL-R?

A

Recognizes B100 molecule on the surface of its lipoprotein target; cell surface expression of this is increased on hepatocytes when their ability to synthesize new cholesterol and/or delivery of dietary cholesterol is impaired and when bile acids are lost in the stool rather than recycled

32
Q

What is the fate of LDL-R in the absence of PCSK9 binding?

A

recycled

33
Q

What hormone lowers HDL?

A

Androgens

34
Q

What is NPC1L1?

A

Transport protein in the apical membrane of SI enterocytes and the canalicular membrane of hepatocytes; it absorbs cholesterol and plant sterols

35
Q

What is a common adverse effect of statins in association with normal Cr kinase levels?

A

Myalgia; incidence increases by age, female sex, low BMI, various drugs and comorbidities, alcohol and high levels of physical activity or trauma

36
Q

What is pravastatin?

A

HMG-CoA reductase inhibitor

37
Q

Which vitamins are not absorbed well if bile acid sequestrants (especially cholestyramine or colestipol) are administered?

A

fat soluble vitamins

38
Q

What is an absolute contraindication for statins?

A

Pregnancy

39
Q

what is rosuvastatin?

A

HMG-CoA reductase inhibitor, med high subclass

40
Q

LDL cholesterol that is >190 is what?

A

very high

41
Q

What is a major challenge when treating pts for HLD?

A

adherence

42
Q

What is ezetimibe?

A

NPC1L1 inhibitor; generally well tolerated with some experiencing HA, runny nose and/or sore throat

43
Q

What is the normal range for total cholesterol in adults over the age of 20?

A

135-200

44
Q

What is the largest lipoprotein and what is their function?

A

Chylomicrons; formed in the enterocytes to transport fats absorbed from the diet

45
Q

What ancestry increases the risk of myalgia in those using stains?

A

asian

46
Q

Which drug is the preferred alternative for those unable to tolerate statins?

A

Ezetimibe; and the preferred add on if greater LDL-C lowering is needed despite statin use

47
Q

What behavior lowers HDL?

A

smoking

48
Q

what is a common adverse effect of niacin?

A

Pruritus; possible reason for use of bile acid sequestrants if caused by cholestasis

49
Q

What is the range for high cholesterol?

A

160-189 in adults

50
Q

What is B48?

A

apolipoprotein that is characteristic of chylomicrons and their remnants

CPR II Exam 1 (11 decks)

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