Dyslipidemia drugs (Lab) Flashcards
Atorvastatin brand name
Lipitor
Rosuvastatin brand name
Crestor
Simvastatin brand
Zocor
Pravastatin brand
Pravachol
Lovastatin brand
-Altoprev
-Mevacor
Pitavastatin brand
Livalo
Fluvastatin brand
Lescol
Statins
- -Atorvastatin (Lipitor)
-Rosuvastatin (Crestor)
-Simvastatin (Zocor)
-Pravastatin (Pravachol)
-Lovastatin (Altoprev, Mevacor)
-Pitavastatin (Livalo)
-Fluvastatin (Lescol)
Cholesterol absorption inhibitors
-ezetimibe (Zetia)
Ezetimibe brand
Zetia
PSCK-9 inhibitors
EvolocuMAB (Repatha)
AlirocuMAB (Praluent)
Evolocumab brand
Repatha
Alicorumab brand
Praluent
Bile aCid sequestrants
-Cholestyramine (Questran)
-Colsevelem (Welchol)
-Colestipol (Colestid)
Cholestyramine brand
Questran
Colsevelem brand
Welchol
Colestipol brand
Colestid
Fibrates
-Fenofibrate (Tricor)
-Gemfibrozil (Lopid)
Fenofibrate brand
Tricor
Gemfibrozil brand
Lopid
Omega-3 fatty acids
-Omega-3 fatty acid (Lovaza)
-Icosapent ethyl (Vascepa)
Omega-3 FA brand
Lovaza
Icosapent ethyl brand
Vascepa
Niacin brand
Niacor
Better for TG level
-fibrates
-omega 3
Statin considerations
-well tolerated
-obtain LFTs at baseline
-muscle toxicity
-darker urine
-avoid grapefruit juice
-NOT IN PREGNANCY
-maybe hyperglycemia
Statin adverse effects risk factors
-renal/hepatic impairment
-statin intolerance
-muscle disorders
-unexplained ALT elevations
-other drugs
-over 75 years old
Statin contraindications
-acute liver disease
-unexplained persistnat elevation of serum transaminases
-pregnancy
-breastfeeding
Statins and muscle injury
-myalgias
-myositis
-rhabdomylosis
Statin monitoring
-obtain LFT at baseline
-repeat LFT when indicated
-dc if over 3x normal limit
-FLP at baseline
-4-12 weeks later
-every 3-12 months
Simvastatin interactions
-conazoles
-mycins
-gemfibrozil
->10mg w verapamil and diltiazem
->20mg amiodarone, amlodipine, ranolazine
Bile Acid Resins adverse effects
-inc TG
-take other meds 1 before or 4 hours after
-GI effects
-dec fat-soluble vitamin absorption
-hypernatremia
-hyperchloremia
-GI obstruction
cholestyramine (BAR) contraindications
-complete biliary obstruction
Colesevelam (BAR) contraindications
-hx bowel obstruction
-serum TG > 500
-hx hyperTG-induced pancreatitis
BARs interactions
-acetaminophen
-TZDs
-contraceptives
-corticosteroids
-ezetimbibe
-fibrates
-thiazide diuretics
-warfarin
-digoxin
Niacin considerations
-OTC not as regulated
-some sustained release forms associated w hepatotoxicity
-flushing and itching from prostaglandins
Niacin (Niacor) flushing
-admin ASA 30min before niacin
-take close to meal
-avoid alc and hot drinks
-start lower dose and titrate
Niacin adverse effects
-flushing
-inc LFTs
-hyperuricemia and hyperglycemia
-may inc statin levels
Niacin contraindications
-hepatic disease
-liver transaminase elevations
-peptic ulcer
-arterial hemorrhage
Ezetimibe (zetia)
-combo w simvastatin
ezetimibe adverse effects
-fatigue
-diarrhea
-GI upset
Ezetimibe contraindications
-w statin and hepatic disease/elevated transaminase
-pregnancy
-breastfeeding
-all w statin
Fibrates adverse effects
-GI
-rash
-myalgia
-dizziness
Fibrate contraindications
-history of gallbladder disease
-ESRD or dialysis
-liver disease
Fibrates inc levels of
-statins
-ezetimibe
-sulfonylureas
-warfarin
PSCK9 moa
-inj
-use in heterozygous hypercholesteroemia or artherosclertotic CVD
PSCK9 side effects
-GI
-inc LFTs
-myalgia
-flu
-site pain
PCSK9 used for
-ASCVD reduction in stable ASCVD
-very high risk or statin intolerant
-if LDL over 190 after max statin + ezetimibe