Dyslipidemia

Question 1

Name the HMG -CoA Reductase inhibitors , MOA and side effects

Answer 1

Lovastatin
Pavarstatin
Simvastatin ZOCOR
Atorvastatin LIPITOR
Rosuvastatin CRESTOR

MOA : these drugs inhibit the enzyme HMG CoA refuctase .. preventing the formation of mevalonate .. thus preventing cholesterol formation .. this increase the receptors on liver enzymes and increase the uptake of circulating LDL thus decreasing the amount of LDL in the blood .
Good for use in CVD

SE:
Hepotocity
Myopathy / rhabdomylysis
GI upset

Question 2

Name the drugs that are in the NIACIN CLASS their MODE OF ACTION and Side effects

Answer 2

Vit. B3
Decrease triglyceride synthesis by 30 -70 %

Reduce fatty acid by decreasing lipolysis .

Decrease HDL Catabolic Rate thus increasing HDL level

Side effects :
Hyperuricemia
Hyperglycemia
ITCHING , Rash FLUSHING caused by vasodilation

Question 3

what is the MOA for Ezetimibe 10 mg and what is the Major side effects

Answer 3

Decrease the absorption of cholesterol from the brush borders in the intesting to the blood thus lowering the Cholesterol level .

SE; if taking with fibrates it can increase the risk of Gallstone

Question 4

which of the following drugs increase the execration of uric acid thus can bee use to treat gout .

Answer 4

a. clofibrates
b. Vit B 3
C. atorvastatin
d. ezetimebe

Question 5

Name the different fibrates there mechanism of action and side effects

Answer 5

Benzo \Clo \ Feno fibrates

they increase the activity of the lipoprotien lipase that breaks down VLDL no VLDL no LDL

S\E Gall stone , Rhabdomyolysis , myopathy

Question 6

what is the interaction between the fibrates and Warfarin / anticoagulants

Answer 6

increases risk of bleeding because in increases fibrinolysis .

Question 7

what drugs falls in the PSK9 inhibitors class and how does it work

Answer 7

aliro / evolo CUMAB

PROLUENT

REPATHA

PSK9 inactivates the Receptors on the liver cells that are responsible to take up LDL from the blood to make cholesterol .

Question 8

What are the Bile Acid Resins and how do they work

Answer 8

Cholestyramine and Colestipol

MOA: by biding to Bile Acids and Its Salts they prevents the reabsorption of Bile acid to go back to the liver thus the liver increase uptake of LDL to make bile acids.

S/E
Gas
bloating and constipation

Question 9

How would you rank the different class of drug interm of effects on LDL

Answer 9

1. HMG CoA reductase inhibitors
   (statins) 18-55%
2. Bile Acid Sequestrants 15-30%
3. Nicotinic acid 5-20↓%
4. Fibric Acid 5-25↓%

Question 10

How would you rank the different class of drug interm of effects on triglyceride and HDL level

Answer 10

1. Nicotinic acid 20-50↓ …………… HDL 15-35↑
2. Fibric Acid 20-50↓ ……………. HDL 10-20↑
3. HMG CoA reductase inhibitors (statins) 7-30↓. ………… HDL 5-15↑
4. Bile Acid Sequestrants no change ……….. HDL 3-5↑

Question 11

base on the AHA /ACC Guidelines what are the Four main statin benefit groups

Answer 11

ASCVD -< or = 75 high intensity statin : > /= 75 moderate intensity statin

LDL > 190 high intensity Statin

With diabetes and between the age of 40 to 75 - 10 year risk > than 7.5 give high intensity but < 7.5 give moderate intensity

if 40 to 75 and no diabetes or ASCVD but 10 year risk > 7.5 % GIVE moderate to high intensity statin

Question 12

Which 3 drug class increase the uptake of LDL from the blood

Answer 12

Bile Acid Resin
HMG-CoA inhibitor
Psk9 inhibitors