Dyslipidemia 2 Flashcards
1
Q
Which drug?
- MOA: Decrease LDL and VLDL synthesis
- Effects on lipids: Decreases TG and Cholesterol
- Effects on lipo: Increases HDL
- Misc: Issues w/ pt acceptance, extended release causes less flushing and is less hepatotoxic than sustained release
A
Niacin
2
Q
Which drug?
- MOA: Increase LDL catabolism and Inhibit LDL synthesis
- Effect on lipids: decrease cholesterol
- Effects on lipo: decrease LDL
- Misc: highly effective in heterozygous familial hypercholesteremia and in combo w/ other agents
A
- Atorvastatin
- Rosuvastatin
3
Q
Which drug?
- MOA: PCSK9 inhibitor
- Effect on lipids: decreases cholesterol and Lpa
- Effects on lipo: decreases cholesterol and LDL
- Misc: Given by SQ injection, injection site pain, low risk of hepatotoxicity
A
- Alirocumab
- Evolocumab
4
Q
Which drug?
- MOA: Blocks cholesterol absorption across the intestinal border
- Effects on lipo: decreases LDL
- Misc: Few adverse effects
A
Ezetimibe
5
Q
MOA of which drug class?
-
Inhibition of HMG-CoA reductase
- Directly reduces production of cholesterol
-
LDL receptors upregulated in liver
- Indirectly increases LDL catabolism
- Has “pleiotropic effects” such as improving endothelial function, enhances stability of atherosclerotic plaques, decreases oxidative stress, inhibits thrombogenic response
-
Prevention of atherosclerosis
- Controls inflammatory response
A
Statins
6
Q
Which class of drugs?
- Primary effect is on LDL
- Increases HDL 5-10%
- Decreases TGs 10-30%
- Prevention of atherosclerosis (controls inflammatory response)
A
Statins
7
Q
- Which Statin is the most potent?
- Which Statin have the greatest efficacy?
(to reduce % of LDL)
A
Rosuvastatin
8
Q
Which Statin is the worst at reducing LDL?
A
At 80mg, Fluva
9
Q
- A high-Intensity Statin Therapy lowers LDL on average by what %?
- How many mg are in high-intensity statins?
A
- 50% or greater
- Atorvastatin 40 - 80 mg
- Rosuvastatin 20 - 40 mg
10
Q
- Moderate Intensity Statin Therapy lowers LDL on average by what %?
- 4 names of these drugs apart from Atorv and Rosuv?
A
- 30 - <50%
- Simvastatin 20 - 40mg
- Pravastatin 40 - 80mg
- Lovastatin 40mg
- Fluvastatin 40mg
11
Q
- Low - Intensity Statin Therapy lower LDL on average by what %?
- 2 names of these?
A
- <30%
- Pravastatin 10-20mg
- Lovastatin 20mg
12
Q
CYP Hepatic Enzyme (3A4) is associated w/ which Statin?
A
Atorvastatin
13
Q
CYP Hepatic Enzyme (2C9) is associated w/ which Statin?
A
Rosuvastatin
14
Q
Which statin has a higher bioavailability?
Atorvastatin or Rosuvastatin?
A
Rosuvastatin = 20
Atorvastatin = 14
15
Q
Which class of drugs?
- Contraindications: Active liver disease & pregnancy
- SE: arthralgia, myalgia, rhabdomyolysis, hepatic failure, musculoskeletal pain (low back)
- Caution: possibly reduced dosage in patients w/ hepatic parenchymal disease, north Asians, and elderly
A
Statins