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CV PHAR 152 > Dyslipidemia > Flashcards

Dyslipidemia Flashcards

1
Q

Low Risk FRS _____
LDL _______

A

<10%
5 mmol/L

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2
Q

Intermediate Risk FRS _____
LDL _______

A

10-19.9%
>3.5 mmol/L

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3
Q

High Risk FRS _____
LDL _______

A

> 20%
There is not threshold for LDL

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4
Q

What is Lp(a)

A

LDL covalently bonded to Apo A
highly genetic predisposition

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5
Q

What is another name for statin?

A

HMG-CoA reductase inhibitor

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6
Q

MOA of stains

A

stops the intracellular synthesis of cholesterol

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7
Q

What is the primary site for statins?

A

hepatic cells

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8
Q

What are the two major statins?

A

rosuvastatin
atorvastatin

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9
Q

What are the goals for LDL for DB or CKD?

A

LDL > 2

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10
Q

What is the goal for LDL for ASCVD?

A

LDL >1.8

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11
Q

What is the level of triglycerides for ASCVD?

A

1.5-5.6

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12
Q

What is the goal for low risk pt?

A

LDL >2.5

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13
Q

What is second line if you do not reach goal?

A

Add ezetimibe or PCSK9 inhibitor

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14
Q

What are the clinical benefits to statins?

A

lowering LDL
lowering all lipids but more
lowering in risk for benefits

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15
Q

What are some things that studies prove about statins?

A

statins decrease the rate of major vascular events

higher potency statins will provide greater benefits

lowering LDL decrease risk of ischemic events

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16
Q

What are some effects on other plasma lipids from statins?

A

HDL increase 5-10%
TG decrease up to 30%
benefits are unclear

17
Q

What are some controversial thoughts on statins?

A

low risk pt being on statins as primary prevention
does have some reduction of risk if they already have evidence of CHD

18
Q

What is the guidelines for statin dosing?

A

highest potency that they can tolerate

19
Q

What are some exception of high dose statins?

A

intolerance
DI
pt. preference

20
Q

MOA of PCSK9

A

promotes degradation of LDL receptor
monoclonal antibodies

21
Q

MOA of ezetimibe

A

decrease the absorption in the small intestine
do not use as monotherapy

22
Q

What level of affect does eze and PCSK9?

A

Eze decrease 17%
PCSK9 decreases 55%

23
Q

What are some nuisance side effects from statins?

A

GI upset
fatigue

24
Q

What are some concerning side effects from statins?

A

DB –> small risk
cognitive impairment (memory loss)
muscle effects (pain)

25
Q

What are the levels of muscle pain?

A

myopathy
myalgia
myositis
rhabdomyolysis

26
Q

What is the difference between the level of muscle pain?

A

the level of Cr, level of muscle damage

27
Q

What are some pharmacokinetics of statins?

A

3A4 enzyme
it contracts with grapefruit juice
hepatic metabolism

28
Q

What are some other drugs used instead of statins?

A

Niacin
Fibric Acid
Omega-3 FA

29
Q

MOA of niacin

A

B vit
increase HDL by decreasing Apo AI

30
Q

MOA of fibric acid

A

bind to PPARa
decrease TG

31
Q

MOA of Omega -3 FA

A

decreased VLDL TG’s

CV PHAR 152 (4 decks)

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