Dyslipidemia Flashcards
What are the 4 types of lipid lowering therapeutics?
HMG CoA Reductase inhibitors
Fibrates
Niacin
Cholesterol Absorption inhibitors
What are the normal and borderline numbers for total cholesterol?
Normal:
What are the normal and borderline numbers for LDL cholesterol?
Normal:
What are the normal and borderline numbers for HDL cholesterol?
Normal: > 60
Borderline: 35-60
What class of lipid lowering drug is Atrovastatin?
HMG CoA reductase inhibitor (statin)
What are the 2 indications for Atrovastatin?
Dyslipidemia
CVD prevention
What is the MOA of Atrovastatin?
Inhibits HMG-CoA reductase
Increases hepatic LDL receptors, enhancing catabolism
What is HMG-CoA reductase responsible for?
An early, rate-limiting step in cholesterol biosynthesis
What are the 5 common adverse effects of Atrovastatin?
Nasopharyngitis Myalgia Skeletal myopathy Impaired hepatic function associated with elevated serum transaminase levels Jaundice
What are the 7 potential ocular side effects of Atrovastatin?
Diplopia Elevated IOP Ptosis Pseudo-CME Intraocular hemorrhage Cataracts Blurred vision
What is the 1 contraindicated drug for Atrovastatin?
Azoles
Which drugs interact with Atrovastatin to cause myopathy exacerbation?
Cyclospoirne
Erythromycin
Azoles
What class of lipid lowering drug is Fenofibrate?
Fibrate
What are the 3 indications for Fenofibrate?
Hypertriglyceridemia
Hypercholesterolemia
Combo with statins, or for statin intolerant patients
What is the MOA of Fenofibrate?
Stimulates nuclear receptor PPAR, which modulates transcription of insulin sensitive genes in liver, muscle, and adipose tissue
Enhances HDL production, inhibits triglyceride synthesis
What are the 3 common side effects of Fenofibrate?
Headache
Rhinits
Flu syndrome
What are the 7 serious side effects of Fenofibrate?
Hypersensitivity: SJS, TEN
Hepatic: Hepatitis, Cirrhosis
CV: Thromboembolism
Muscular: Myositis, myopathy, rhabdo
Which drugs interact with Fenofibrate to impair renal elimination?
Acyclovir
Aminoglycosides
Cyclosporin
Ganciclovir
Which drug interacts with Fenofibrate to cause impaired metabolism?
Sulfonylureas
What are the 3 indications for Niacin?
Hypertriglyceridemia
Hypercholesterolemia
Mixed dyslipidemia
What is the MOA of Niacin in dislypidemia?
Inhibits lipolysis in adipose tissue, resulting in reduced hepatic VLDL synthesis and production of LDLs in the plasma
Niacin is the most effective agent for increasing what?
HDL
What are the 9 common adverse effects of Niacin?
Headache Pseudo CME Flushing Pruritus Hyperpigmentation Jaundice Xeroderma Toxic amblyopia Orthostatic hypotension
What are the 2 serious adverse effects of Niacin?
Hepatotoxicity
Arrhythmias
What does niacin induce that causes flushing and/or Mueller cell toxicity?
Prostaglandin D2 production
What drugs interact with Niacin to cause an additive effect?
Alpha and Beta blockers
Cautions need to be taken when Rxing Niacin with what two conditions?
Diabetes - elevates sugar
Surgery - anti-platelet effects
What class of dyslipidemia drug is Ezetimibe?
Cholesterol Absorption Inhibitor
What is the MOA of ezetimibe?
Inhibits dietary and biliary cholesterol absorption as the small intestine brush border
What are the 3 common adverse effects to Ezetimbe?
Sinusitis
Flu
Diarrhea
What are the 4 serious adverse effects of Ezetimibe?
Angioedema, anaphylaxis
Hepatitis
Thrombocytopenia
What drug may interact with Ezetimibe to elevate the levels of both drugs?
Cyclosporine
What is the one caution with Ezetimibe?
Hepatic impairment
