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Pharm II > Dyslipidemia- Guidelines - DONE > Flashcards

Dyslipidemia- Guidelines - DONE Flashcards

1
Q

What is the primary target for treatment of patients with dyslipidemia?

A

LDL (low density lipoprotein?

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2
Q

What is the INITIAL therapy for ANY lipoprotein disorder?

A

lifestyle changes

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3
Q

T/F Lipid-lowering therapy should be chosen based on the specific lipoprotein disorder?

A

true

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4
Q

T/F Low high-density lipoprotein (HDL) is addressed with lifestyle changes, increased exercise and specific pharmacologic agents.

A

true

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5
Q

________ - abnormal blood lipid profiles that can be comprised of hypertriglyceridemia (hyperlipidemia), hypercholesterolemia, hypoerlipoproteinemia, or elevated fatty acids or any combination of these.

A

Dyslipidemia

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6
Q

Dyslipidemia can arise from a variety of of factors, major factors are dietary, genetic, and disease mediated.
What are the two MAJOR CLINICAL secondary consequences of dyslipidemia?

A

Acute Pancreatitis and Atherosclerosis

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7
Q

______ = The formation of plaques which cause CVD and stroke upon rupture.

A

Atherosclerosis

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8
Q

What ist he leading cause of death in the US for both men and women?

A

atherosclerosis

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9
Q

What are large lipoprotein particles that transport absorbed dietary fats from intestine to peripheral tissues and liver?

A

Chylomicrons

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10
Q

What are large lipoprotein particles produced by the liver and released into the systemic circulation?

A

Very Low Density Lipoprotein (VLDL)

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11
Q

What are the precursors to LDL?

A

VLDL

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12
Q

What are known as “bad cholesterol”?

A

LDL - low density lipoproteins

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13
Q

Low density Lipoprotein (LDL) is a lipoprotein particle delivered from VLDL following loss of what??

A

triglycerides by peripheral lipoprotein lipase (LPL)

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14
Q

How is LDL cleared from the circulation?

A

LDL receptor on the liver binds ApoB100 protein in LDL particles

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15
Q

What are known as “good cholesterol”?

A

High density lipoprotein (HDL)

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16
Q

What mediates reverse cholesterol transport (taking cholesterol out of peripheral tissues such as atherosclerotic plaques and facilitating its excretion)?

A

HDL

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17
Q

How is HDL excreted?

A

taken up by liver and cholesterol component is excreted as bile salts

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18
Q

What is the storage form of fatty acid in the body?

A

Triglyceride

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19
Q

What is the major lipid constituent of plasma lipoproteins?

A

triglyceride

20
Q

What is the first step in lipoprotein metabolism?

A

-

21
Q

What is the second step in lipoprotein metabolism?

A

-

22
Q

What is the second step in lipoprotein metabolism?

A

-

23
Q

What is the 4th step in lipoprotein metabolism?

A

-

24
Q

What are the three ATP III Guidelines to the primary prevention with LDL-Lowing therapy [Public Health Approach]?

A
  1. Reduce intakes of saturated fat and cholesterol
  2. increased physical therapy
  3. weight control
25
Q

What is the goal of long term primary prevention?

A

> 10 years

26
Q

What is the goal of short term prevention?

A

less than or equal to 10 years

27
Q

What are the 5 causes of Secondary Dyslipidemia?

A
  1. diabetes
  2. hypothyroidism
  3. obstructive liver disease
  4. chronic renal failure
  5. drugs that raise LDL cholesterol and lower HDL cholesterol
28
Q

What are 3 drugs that cause secondary dyslipidemia?

A
  1. progestins
  2. anabolic steroids
  3. corticosteroids
29
Q

What are the benefits to secondary prevention with LDL-Lowering therapy?

A

reduction in total mortality, coronary mortality, major coronary events, coronary procedure, and strokes

30
Q

What is the mg/dL goal of lowering LDL cholesterol?

[according to secondary prevention with LDL lowering therapy ATP III guidelines]

A

<100 mg/dL

31
Q

When should u consider initiation of secondary prevention with LDL - Lowering therapy during hospitalization? [mg/dL?]

A

when it is greater than or equal to 100 mg/dL

32
Q

A patient is at risk for CHD or CHD risk equivalents (10 - year risk >20%) ….

  1. what is their LDL goal?
  2. LDL level at which to initiate therapeutic lifestyle changes?
  3. LDL level at which to consider drug therapy?
A
  1. than or equal to 100

3. >than or equal to 130 (100-129: drug optional)

33
Q

A patient has 2 + risk factors (10 year risk less than or equal to 20%)

  1. what is their LDL goal?
  2. LDL level at which to initiate therapeutic lifestyle changes?
  3. LDL level at which to consider drug therapy?
A
  1. that or equal to 130

3. if a 10 year risk is 10-20% = > or equal to 130 ; if a 10 year risk is or equal to 160

34
Q

A patient has 0-1 risk factors

  1. LDL goal?
  2. LDL level at which to initiate therapeutic lifestyle changes?
  3. LDL level at which to consider drug therapy?
A
  1. < 160
  2. > or equal to 160
  3. > or equal to 190 (160-189: LDL- lowering drug therapy optional)
35
Q

LDL -Lowering Therapy in Patients with CHD & CHD Risk Equivalents with a baseline LDL cholesterol of _____ should ……

  1. Intensive Lifestyle Therapies
  2. Maximal Control of other risk factors
  3. consider starting LDL lowering drugs simultaneously with lifestyle changes.
A

greater than or equal to 130 mg/dL

36
Q

LDL- lowering Therapy in patients with CHD and CHD risk equivalents with a baseline or on treatment LDL-C of _______ should..
3 therapeutic options DESCRIBE EACH OF THESE
1. LDL - lowering therapy
2. treat metabolic syndrome
3. drug therapy for other lipid risk factors

A

LDL-C : 100-129 mg/dL

  1. initiate or intensify lifestyle therapies; initiate or intensify LDL lowering drugs
  2. emphasize weigh reduction and increased physical activity
  3. for high triglycerides/low HDL cholesterol ; fibrates or nicotinic acid
37
Q

LDL baseline of ____

  • further LDL lowering NOW required
  • Therapeutic Lifestyle Changes (TLC) recommended
  • consider treatment of other lipid risk factors (elevated triglycerides, low HDL cholesterol)
  • Ongoing clinical trials are assessing benefit of further LDL lowering
A
38
Q

LDL Lowering Therapy in Patients with Multiple (2+) Risk factors and 10 year risk 10-20%

  1. What is their LDL cholesterol goal?
  2. what are you aiming to do?
  3. When do you consider immediate initiation of 4. Therapeutic lifestyle changes (TLC)?
  4. When do you consider drug therapy?
A
  1. LDL goal of or equal to 130

4. Drug therapy = > or equal to 130 after 3 months of lifestyle therapies

39
Q

What is the LDL-cholesterol goal of a patient with a 10-Year risk <10%?

A

<130 mg/dL

40
Q

What is the therapeutic aim of a patient with a 10-year risk <10%?

A

reduce long-term risk

41
Q

T/F: In a patient with multiple (2+) risk factors and 10-yr risk or equal to 130 mg/dL.

A

TRUE

42
Q

T/F In a patient with multiple (2+) risk factors and 10-yr risk or equal to 160 mg/dL after 3 months of lifestyle therapies.

A

TRUE

43
Q

What are the guidelines for LDL-lowering therapy in patients with 0-1 Risk factor?

A
  1. Most persons have 10-yr risk 160 mg/dL
  2. if LDL-C is >190 mg/dL after 3 mths of lifestyle therapies, consider drug therapy
  3. if LDL-C is 160-189 mg/dl after 3 mths of lifestyle therapies, drug therapy is optional
44
Q

What are factors favoring drug therapy in patients with 0-1 risk factor and LDL-C 160-189 mg/dL (after lifestyle therapies)?

A
  1. severe single risk factor

2. multiple life-habit risk factors and emerging risk factors (if measured)

45
Q

What are the general features of Metabolic syndrome?

A
  1. abdominal obesity
  2. atherogenic dyslipidemia (inc. TG, low HDL, sm. LDL particles)
  3. raised BP
  4. insulin resistance
  5. prothombotic state
  6. proinflammatory state

Pharm II (13 decks)

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