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Dyslipidemia Flashcards

1
Q

Calculation for Non-HDL

A

TC-HDL

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2
Q

What can elevated TG cause

A

acute pancreatitis

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3
Q

Friedewald equation

A

LDL = TC - HDL - TG/5

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4
Q

When can you not use the friedewald equation

A

when TG > 400 mg/dL

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5
Q

Drugs that raise LDL and TG (4)

A

Protease Inhibitors
Steroids
Diuretics
Immunosuppressants

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6
Q

Drugs that raise LDL only (2)

A

Fibrates

SGLT2 inhibitors

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7
Q

Drugs that raise TG only (4)

A

IV lipid emulsions
propofol
beta-blockers
atypical antipsychotics

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8
Q

Conditions that raise LDL and TG (6)

A 
obesity
hypothyroidism
alcoholism
smoking
diabetes
renal/liver disease
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9
Q

Desirable LDL level

A

<100

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10
Q

Very high LDL level

A

> 190

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11
Q

desirable HDL level

A

men >40

women > 50

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12
Q

Normal TG levels

A

< 150

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13
Q

Very high TG levels

A

> 500

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14
Q

Natural product used to lower cholesterol

A

Red yeast rice

-contain naturally occurring HMG-CoA reductase inhibitors

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15
Q

What ASCVD risk score indicated to start a statin

A

> 7.5%

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16
Q

Risk-enhancing factors for ASCVD (10)

A 
very high LDL
family history of premature ASCVD
metabolic syndrome
chronic kidney disease
history or preeclampisa
history of premature menopause
chronic inflammatory disorders
high CRP
high CAC
abnormal ABI
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17
Q

A CAC score of what indicated use of a statin

A

> 100

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18
Q

High-intensity statin group

A

LDL >190
DM 40-75 with LDL 70-189 and multiple ASCVD risk factors
40-75 w/ LDL 70-189 with 10-yr ASCVD > 20%

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19
Q

Moderate-intensity statin group

A

DM 40-75 with LDL 70-189

40-75 with LDL 70-189 and 10-y ASCVD 7.5-19.9%

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20
Q

List high intensity statins

A

Atorvastatin 40-80

Rosuvastatin 20-40

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21
Q

What % do high intensity statins lower cholesterol by?

A

50%

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22
Q

List Moderate intensity statins

A 
Atorvastatin 10-20
Rosuvastatin 5-10
Simvastatin 20-40
Pravastatin 40-80
Lovastatin 40
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23
Q

What % do moderate intensity statins lower cholesterol by?

24
Q

List low intensity statins

A

simvastatin 10
pravastatin 10-20
lovastatin 20

25
Q

What % do low intensity statins lower cholesterol by?

26
Q

Which cholesterol lowering drugs cause liver damage (4)

A

Niacin
fibrates
exetimibe
potentially statins

27
Q

Statin MOA

A

inhibit the enzyme HMG-CoA reductase which prevents the conversion of HMG-CoA to mevalonate. this is the rate-limiting step in cholesterol synthesis

28
Q

define myalgias

A

muscle soreness and tenderness

29
Q

define myopathy

A

muscle weakness +/- CPK elevations

30
Q

define myositis

A

muscle inflammation

31
Q

define rhabdomyolysis

A

muscle symptoms with very high CPK (>10000) + muscle protein in the urine (myoglobinuria) which leads to acute renal failure

32
Q

gemfibrozil + statin DDI

33
Q

Which statins need taken in the evening

A

simvastatin

lovastatin

34
Q

which statins are CI with strong cyp3a4 inhibitors

A

simvastatin

lovastatin

35
Q

statins + niacin DDI

A

myopathies

36
Q

Max dose of simvastatin when used with CCB

37
Q

Max dose of simvastatin when used with amiodarone, smlodipine

38
Q

ezitimibe MOA

A

inhibits absorption of cholesterol in the small intestine

39
Q

PCSK9 inhibitors MOA

A

bind to proprotein convertase subtilisin kexin type 9. PSCK9 inhibitors inhibit the binding of PCSK9 to LDL receptors thus increase the number of LDL receptors available to clear LDL

40
Q

List PCSK9i

A

Alirocumab

Evolucumab

41
Q

Bile Acid sequestrants MOA

A

bind bile acids in the intestines, forming a complex that is excreted in the feces

42
Q

List BAS

A

Cholestyramine
colesevelam
colestipol

43
Q

Which BAS can a pregnant women use

A

cholesevelam

44
Q

Fibrates MOA

A

peroxisome proliferator receptor alpha (PPARa) activators, which upregulate the expression of apolipoprotein c2 and apolipoprotein A1. apoc-2 increases lipoprotein lipase activity leading to increased catbolism of BLDL particles. this will decrease TG significally

45
Q

List fibrates

A

fenofibrate

gemfibrozil

46
Q

CI for fibrates

A

severe liver disease including primary biliary cirrhosis

gallbladder disease

47
Q

Niacin MOA

A

decreases rate of hepatic synthesis of VLDL (decreases TG) and LDL

48
Q

What is niacin also known as?

A

nicotinic acid

vitamin B3

49
Q

Major SE of niacin

50
Q

How to reduce flushing in niacin

A

ASA 325 30-60 min before dose

51
Q

When are fish oil indicated

52
Q

List fish oils

A

omega-3 acid ethyl esters (lovaza)
-has EPA and DHA
icosapent ethyl (Vascepa)
-has EOA

53
Q

fish oil effect on LDL

A

Lovaza can inc by 44%

no increase seen with vascepa

54
Q

Lomitapide MOA

A

binds to and inhibits microsomal TG transer protein (MTP) which prevents the assembly of apoB containing lipoproteins

55
Q

Mipomersen MOA

A

oligonucleotide inhibitor of apoB synthesis

56
Q

Indication for lomitapide and mipomersen

A

Homozygous familial hypercholesterolemia

NAPLEX (65 decks)

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