Dyslipidemia Drugs: Statins

Question 1

What is the site of free fatty acid and cholesterol absorption

Answer 1

lumen of small intestine

Question 2

Cholesterol esters are packaged into the interior of chylomicrons in

Answer 2

intestinal cells

Question 3

_______ make up most of the chylomicron

Answer 3

triglycerides

Question 4

Chylomicrons contain

Answer 4

surface apolipoproteins A, B, C, and E

Question 5

Chylomicrons deliver triglycerides from the

Answer 5

intestine to peripheral tissues

Question 6

Triglycerides in chylomicrons and VLDLs are hydrolyzed by

Answer 6

LPL, releasing free fatty acids

Question 7

Free fatty acids can be

Answer 7

1. used for energy by heart and skeletal muscle

2. converted back into triglycerides and stored in adipose tissue

Question 8

Chylomicron remnants return to the

Answer 8

liver

Question 9

The LDL receptor binds to

Answer 9

ApoE and transports chylomicron remnant into liver via endocytosis

Question 10

Cholesterol from chylomicron remnants are used by

Answer 10

the liver

Question 11

HMG CoA reductase synthesizes

Answer 11

cholesterol in the liver

Question 12

The first intermediate in cholesterol synthesis is

Answer 12

mevalonic acid

Question 13

_______ make up most (~60%) of the VLDL

Answer 13

triglycerides

Question 14

Cholesterol esters are packaged into the interior of VLDLs in

Answer 14

hepatocytes

Question 15

Apolipoprotein B100 is found on

Answer 15

“bad cholesterol” (LDL and VLDL)

Question 16

VLDLs deliver triglycerides from the liver to

Answer 16

peripheral tissues

Question 17

Low density lipoprotein (LDL) is formed as

Answer 17

VLDLs lose triglycerides via LPL and hepatic lipase

Question 18

LDLs contain a core of

Answer 18

cholesterol esters

Question 19

LDLs deliver cholesterol to

Answer 19

peripheral tissues expressing LDL receptors

Question 20

LDL receptor binds

Answer 20

ApoB and transports LDL particle into liver via endocytosis

Question 21

Nascent HDL is secreted by the

Answer 21

liver and intestine

Question 22

HDL extracts cholesterol from

Answer 22

peripheral tissues

Question 23

Lecithin:cholesterol acyltransferase (LCAT)

Answer 23

converts free cholesterol into cholesterol esters for transport by HDL

Question 24

Mature HDL particle contains

Answer 24

LCAT-generated cholesterol esters

Question 25

HDL transfers

Answer 25

cholesterol esters to LDLs and VLDLs to be transported back to the liver

Question 26

HDL delivers cholesterol esters

Answer 26

directly to the liver via scavenger 1 receptor

Question 27

Statins include

Answer 27

1. simvastatin
2. atorvastatin
3. rosuvastatin

Question 28

Statins inhibit

Answer 28

HMG CoA reductase

Question 29

Statins cause

Answer 29

increased LDL receptor expression on hepatocytes, clearing LDLs from circulation

Question 30

Statins are the most effective drugs for lowering

Answer 30

LDLs (30-60%)

Question 31

Statins can

Answer 31

1. Decrease LDL
2. Decrease Triglycerides
3. Increase HDL

Question 32

Statins have a mild effect on

Answer 32

1. triglycerides

2. HDL

Question 33

Hypercholesterolemia (LDL) is treated with

Answer 33

lifestyle modification and statins (first-line agent)

Question 34

Statins improve

Answer 34

survival

Question 35

Statins are the most effective lipid lowering drug for preventing

Answer 35

future cardiac events

Question 36

Statins are the only lipid-lowering drug consistently proven to

Answer 36

reduce risk of atherosclerotic heart disease

Question 37

Statin therapy is initiated in setting of

Answer 37

MI and other acute coronary syndromes (ACS)

Question 38

statins reduce risk of cardiovascular events and mortality in

Answer 38

1. high-risk diabetics

2. Peripheral artery disease

Question 39

Statins reduce risk of future vascular events in patients with

Answer 39

a history of a TIA or stroke

Question 40

Statins may be

Answer 40

teratogenic

Question 41

Statins can cause

Answer 41

1. myopathy weeks to months after starting therapy (muscle weakness/soreness)
2. elevations in serum CK (myopathy)

Question 42

What effect do statins have on liver function tests

Answer 42

mild elevations in liver function tests (LTFs) are common (reversible with discontinuation of statin)

Question 43

All statins except for pravastatin are metabolized by

Answer 43

cytochrome p450 (CYP-450) in the liver