Dyslipidemia

Question 1

List eight drugs/drug classes that can increase LDL and TG

Answer 1

1. protease inhibitors
2. atypical antipsychotics
3. steroids
4. diuretics
5. transplant drugs (cyclosporine, tacrolimus)
6. oral estrogens and progestins
7. retinoids
8. tamoxifen, raloxifene

Question 2

List three drug classes that can increase LDL

Answer 2

1. Fibric acids
2. SGLT2 inhibitors
3. Thiazolidinediones

Question 3

List six drugs that can increase TG only

Answer 3

1. IV lipid emulsions
2. Propofol
3. Alcohol
4. clevidipine
5. bile acid sequestrants
6. beta blockers

Question 4

List 7 statin equivalent doses from most potent to least potent (HINT: Pharmacists Rock At Saving Lives and Preventing Flu, PRAtSLPrFlu)

Answer 4

1. Pitavastatin 2 mg
2. Rosuvastatin 5 mg
3. Atorvastatin 10 mg
4. Simvastatin 20 mg
5. Lovastatin 40 mg
6. Pravastatin 40 mg
7. Fluvastatin 80 mg

Question 5

List 12 strong CYP3A4 inhibitors that should be avoided with simvastatin and lovastatin

Answer 5

1. itraconazole
2. ketoconazole
3. posaconazole
4. voriconazole
5. erythromycin
6. clarithromycin
7. HIV protease inhibitors
8. cobicistat-containing (Tybost) [Genvoya, Stribild,Evotaz, Prezcobix]
9. nefazodone
10. cyclosporine
11. danazol (with simvastatin)
12. grapefruit juice

Question 6

List two specialty drugs for homozygous familiar hypercholesterolemia and their dosage forms

Answer 6

1. Juxtapid (lomitapide, capsule)

2. Kynamro (mipomersen, prefilled SC syringe)