Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Dyslipidemia > Flashcards

Dyslipidemia Flashcards

1
Q

Why lipoproteins are necessary

A

Triglycerides are an energy source. Cholesterol needed to make: cell membranes, bile acids, and steroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hyperlipidemia

A

Elevated cholesterol, triglycerides, and/or LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Physical exam signs of dyslipidemia

A

Xanthelasma (hands/eyes), circumferential Arcus, PVD (shiny, discolored, hairless), thickened Achilles, htn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Primary hyperlipidemia: what it is, also referred to as

A

Genetic/inherited heterozygous condition resulting in elevated total cholesterol or TG level. Familial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary HLD: numbers, need to get what

A

Total chol >200, tg >500. Thorough family hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary hyperlipidemia: from what 4 other conditions. Drugs that negatively impact/how: 3

A

DM, hypothyroid, chronic renal failure, obstructive liver disease. Inc LDL dec HDL: progestin, corticosteroids, anabolic steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If not fasting, which labs you can use

What indicates need to retest while fasting

A

Only total cholesterol and HDL.

TC >200 or HDL <40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Total cholesterol: desired, borderline, high

A

<200, 200-239, >240

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

HDL: low, high

A

<40. >60.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

LDL:optimal, near optimal, borderline high, high, very high

A

O- <100. 100-129 near optimal. 130-159 borderline. 160-189 high. >190 v high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Old guidelines focused on what

A

Hyperlipidemia, assessment of ASCVD and tx of HLD to a goal LDL number

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

New guidelines focus on what

A

Reduction of ASCVD using statins based on evidence in RCTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Screening: who and how often

A

20 years or older, every 4-6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What to screen: 8

A

Fasting lipoprotein: TC, LDL, HDL, TG. ALT, CK, hba1c. Estimated 10 yr ASCVD risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Primary prevention

A

Therapeutic lifestyle changes:rec for everyone. Reduce sat fats and cholesterol, inc activity, wt control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HDL
Elevated by 3
Lowered by 4

A

Elev: alcohol (1-2), sat fats, weight loss
Low: low fat diet, sugar, excess calories, excess polyunsaturated fats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

LDL:
Elev by 3
Lowered by 3

A

Elev: sat fat, trans fatty acids, dietary cholesterol
Lowered: MUFAs, complex carbs, soy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Total cholesterol
Elev by: 2
Lowered by: 2

A

Elev: sat fats and transfatty acids
Low: substituting MUFAs and complex carbs for sat fats and lowered by soy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

TGs
Elev by 4
Lowered by 2

A

Elev: alc, sugar, high carb diet, excess calories
Low: wt loss and fish oils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What % of calls should be sat fat

Total fat

A

Sat <7%. Total 25-35%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Areas to assess for cv disease

A

Coronary heart disease (angina, MI, PCI, stents, CABG)
PAD (carotid artery disease, extremities, abdominal AA)
Stroke/tia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

RFs in ASCVD risk assessment

9

A

Gender, age, race, tc, HDL, SBP, tx for high bp, dm, smoker

23
Q

4 categories for statin therapy/secondary prevention ASCVD

Intensity of therapy depends on

A

Clinical ASCVD. LDL >190. DM. >7.5% estimated 10 yr risk. Depends on the category

24
Q

Statin therapy reduces risk for who
Moderate intensity does what
High intensity does what

A

Anyone with LDL >70
Moderate: 30-50% reduction LDL
High: >50% reduction LDL

25
Statin therapy recommended for who
Anyone who would exp net benefit of ASCVD risk reduction over potential adverse effects
26
High intensity statin therapy drugs 2
Atorvastatin 80 mg | Rosuvastatin 20 mg
27
Moderate intensity statin therapy
Atorvastatin 40, rosuvastatin 10, simvastatin 20-40, pravastatin 40, love statin 40, fluvastatin 40, few others
28
Low intensity statin therapy
Pravastatin 10-20, lovastation 20, 3 others
29
Statins Class MOA
HMG COA reductase inhibitors. Inhibit the rate limiting enzyme in the formation of cholesterol. Decrease LDLs, decrease TGs, and increase HDLs
30
Statin therapy If <75 If >75
Is less than: high intensity therapy. If greater than or with contraindications to high intensity, should get moderate intensity statin
31
``` Statin tx for primary HLD LDL > ___ Reduction by ___ reduces risk by 20% May require what Assess need to address what ```
>190. >39. Additional use of non statin lipid lowering agents to achieve acceptable lipid reduction. Hypertriglyceridemia.
32
Diabetes Benefits from statins Which intensity
Substantial. Moderate is acceptable. High if 10 yr risk greater than 7.5%
33
Ascvd risk assessment should be completed for who
Pts without ascvd or dm and ldl <190
34
Non statin cholesterol therapy indic for who
High risk (ascvd, ldl >190, diabetes and 40-75) should take it if less than anticipated response to statins, unable to tolerate intensity, or are intolerant. Weigh benefits v risks and drug-drug
35
Areas that need further research 4
Non HDL cholesterol/other biomarkers to guide tx, non invasive imaging to guide risk assessment, 10 yr risk assessment vs lifetime when age to begin statins, others: HF, ESRD on HD, HIV, transplant (groups that haven't been researched)
36
Secondary tx goals 2
Tx elev TGs: if >200 and ldl has been achieved, tx TGs | Tx low HDLs <40: if ldl and tg goals have been met, target HDL
37
Bile acid sequestrants MOA 3 ex
Bind bile acid in intestines, liver uses hepatic cholesterol to produce more bile acids. Effect is to decrease LDL and inc HDL. Questran, colestipol, colesevelam
38
Nicotinic acid | MOA
Reduces production of VLDLs. Reduce LDLs, TGs, and inc HDLs
39
Fibrin acid derivatives MOA Agents
Reduce synthesis and inc breakdown of VLDLs. Reduce LDLs and TGs and inc HDL. Gemfibrozil, fenofibrate, clofibrate
40
Zeta MOA No effect on 2 Intended for use with
Inhibits cholesterol and phytosterol absorption from brush border of intestines. No effect on abs of vit ADEK, no effect on CYP450, use w a statin
41
Zetia | Effect on LDL, other events
When added to simvastatin reduced LDL by 24% and reduces pt of cv death, coronary events, or nonfatal CVA
42
Reduction of LDL by bile acid sequestrant
8-16% when used w statin
43
Statin and fibric acid derivatives Primarily used to what Risk of Contraindicated in
Decrease TGs. Risk myopathies. Dont use in severe liver disease
44
Statin and niacin | Inc risk of
Hepatic dysfunction
45
Lovastatin and simvastatin | Interact with which drugs: 6
Itraconazole, ketoconazole, erythromycin, clarithromycin, gemfibrozil, grapefruit juice
46
Side effects statins Major one Occur with what Indiv at risk: 4
Myopathies, occur w any statin. >80, small frame/frail, imp renal or hepatic system, alcohol abuse
47
Myopathies w statins: drug combos w statins that inc risk 6
Niacin, gemfibrozil, cyclosporine, hiv protease inhibitors, verapamil, amiodarone
48
Pregnant and nursing women should avoid which 4 | One they can use
Dont use: statins, ezetimibe, niacin, fibric acid derivatives Can use bile acid binding resins
49
PCSK9 inhibitors | Benefit seen where
59% ldl reduction. Benefit seen across age, sex, and type of ASCVD regardless of starting LDL level
50
Lopitamide | What it is
Tg transfer protein inhibitor, resides in ER and prevents assembly of Apob lipoproteins in enterocytes and hepatocytes. Inhib synth of chylomicrons and vldl in liver.
51
What is no longer recommended, now what is the goal
No longer: tx to ldl or non HDL cholesterol. Now goal is intensity of statin therapy for ascvd reduction
52
Focus should be assessing for what and If pts fall into which of 4 groups
Risk for ascvd. Clinical ascvd, ldl >189, indiv 40-75 w dm and ldl 70-189 w/o ascvd, indiv 40-75 with dm and ldl 70-189 and a 10 yr risk of 7.5% or higher
53
Intensity of statin therapy based on 4
Presence of clinical ascvd, risk of developing ascvd, presence of dm w/without HLD, or presence of isolated hyperlipidemia (genetic)

Pharmacology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions