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Pharmacy Practice V > Dyslipidemia Medications > Flashcards

Dyslipidemia Medications Flashcards

1
Q

What is considered a MAJOR ASCVD Event?

A
  1. Recent ACS (within past 12 months)
  2. History of MI
  3. History of Ischemic Stroke
  4. Symptomatic Peripheral Artery Disease
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2
Q

What are the high intensity statins?

A
  1. Rosuvastatin 20 or 40
  2. Atorvastatin 40 or 80
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3
Q

What are the moderate intensity statins?

A
  1. Rosuvastatin 5 or 10
  2. Atorvastatin 10 or 20
  3. Simvastatin 20 or 40
  4. Pravastatin 40 or 80
  5. Lovastatin 40 or 80
  6. Fluvastatin 40 BID
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4
Q

What are the low intensity statins?

A
  1. Simvastatin 10
  2. Pravastatin 10 or 20
  3. Lovastatin 20
  4. Fluvastatin 20 or 40
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5
Q

What are the indications for Statins?

A

Hyperlipidemia and ASCVD Prevention

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6
Q

When do you administer Lovastatin?

A

With evening meal, except for XR = HS

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7
Q

When do you administer Atorvastatin and Rosuvastatin?

A

Any time of day

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8
Q

What drugs can increase the concentrations of Simvastatin, Atorvastatin, and Lovastatin?

A

MADVAP
M: Macrolide Antibiotics (clarithromycin and erythromycin)
A: Azole Antifungals
D: Dilitazem
V: Verapamil
A: Amiodarone
P: Protease Inhibitors

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9
Q

What drug can increase the risk of Myopathy in Statins?

A
  1. Gemfibrozil, must AVOID
  2. Fenofibrate
  3. Nicotinic Acid
  4. Cyclosporine A
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10
Q

What are the CI’s of Statins?

A
  1. Active Liver Disease or persistent elevated LFTs
  2. Strong 3A4 Inhibitors (lovastatin/simvastatin)
  3. Pregnancy
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11
Q

What must you monitor prior to initiating Statin therapy?

A

Lipid Panel
Recheck 4-12 wks after
Then 3-12 months after

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12
Q

What type of metabolism is Rosuvastatin?

A

2C9

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13
Q

What type of metabolism is Simvastatin, Atorvastatin, and Lovastatin?

A

3A4

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14
Q

What type of metabolism is Pravastatin?

A

P450

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15
Q

Due to risk of severe myopathy manifested by body aches, must get baseline of what lab to monitor?

A

CPK

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16
Q

Atorvastatin can cause what?

A

Inhibit p-glycoprotein
Or at high doses increase serum dioxin concentrations

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17
Q

Simvastatin has a greater risk of myopathy and rhabdomyolysis with what dose?

A

80 mg, restricted to patients tolerating for >12 months

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18
Q

Simvastatin has drug interactions with what drugs when dosed at <10 mg?

A
  1. Dronedarone
  2. Diltiazem
  3. Verapamil
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19
Q

Simvastatin has drug interactions with what drugs when dosed at <20 mg?

A
  1. Amlodipine
  2. Amiodarone
  3. Ranolazine
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20
Q

What are the Fibrates?

A

Gemfibrozil and Fenofibrate

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21
Q

What are the indications for Gemfibrozil?

A

Hyperlipidemia and Hypertriglyceridemia

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22
Q

What are the DDIs when using Gemfibrozil?

A
  1. Stains = myopathy
  2. Increase WARFARIN
  3. Increase Prandin
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23
Q

What are the CI’s for Gemfibrozil?

A
  1. Hepatic/Renal Dysfunction
  2. Gallbladder Disease
  3. Concurrent use with: Dasabuvir, Repaglinide, Selexipag, or Simvastatin
24
Q

When should Gemfibrozil be taken?

A

On an empty stomach

25
What are the indications for Fenofibrate?
Hypercholesterolemia and Hypertriglyceridemia
26
What are the DDIs when using Fenofibrate?
1. Warfarin 2. Statins
27
What are the CI's for Fenofibrate?
1. Acute Liver Disease 2. Severe Renal Impairment or End Stage Renal Disease 3. Gallbladder Disease
28
When should you avoid the use of Fenofibrate?
CrCl <30
29
What are the warnings for Fenofibrate?
1. Cholelithiasis 2. Increased LFTs 3. Myopathy/Rhabdo 4. Pancreatitis 5. VTE
30
What are the BAS Medications?
Cholestyramine and Colesevelam
31
What are the warnings for ALL BAS meds?
1. AVOID with GI motility problems 2. AVOID with hypertriglyceridemia >300/500 3. History of Pancreatitis
32
What are counseling points for BAS meds?
1. Give with ample fluids 2. Take with meals 3. Take other meds 1 hr before or 4 hrs after
33
What is the indication for Cholestyramine?
Dyslipidemia
34
What are the DDIs and CI of Cholestryramine?
DDI: reduces absorption of many drugs CI: Complete biliary obstruction
35
What are the AEs of Cholestryamine?
Constipation, N/V
36
What is the indication for Colesevelam?
Hyperlipidemia, Type 2 DM
37
What are the CIs for Colesevelam?
1. History of bowel obstruction 2. Serum TG > 500 mg/dL 3. History of hypertriglyceridemia induced pancreatitis
38
What are the AEs of Colesevelam?
Constipation, Dyspepsia, and HA
39
What is the indication of Niacin?
Dyslipidemia (Hypertriglyceridemia)
40
What are the DDIs of Niacin?
Statins
41
What are the CIs of Niacin?
1. Hepatic Dysfunction of Elevated LFTs 2. Active peptic ulcer 3. Arterial Hemorrhage
42
What are the AEs of Niacin?
1. Flushing 2. Pruritus 3. Rash 4. GI: vomit, diarrhea
43
What are the patient counseling points of Niacin?
1. Admin HS with snack 2. Premedicate with ASA or NSAID for flushing 3. Alcohol or Spicy food may intensify flushing
44
What is the indication of Ezetimibe?
Primary Hyperlipidemia
45
What are the DDIs for Ezetimibe?
1. Fibric acids can increase Cp 2. BAS decrease Cp 3. Do NOT use with Gemfibrozil
46
What are the patient counseling points of Ezetimibe?
1. Take without regard to food 2. Do NOT take with 2 hrs before or 3 hrs after BAS 3. Myopathy with concomitant Statin use
47
What is Vytorin?
Simvastatin + Ezetimibe
48
What is the indication for Lovaza?
Hypertriglyceridemia, adjunct to reduce triglycerides in adults with levels >500
49
What are the DDIs for Lovaza?
1. Antiplatelets 2. Anticoagulants
50
What are the cautions of Lovaza?
Fish Allergy Prolongation of Bleeding Time
51
What are the AEs of Lovaza?
1. Belching 2. Dyspepsia 3. Diarrhea 4. Taste Disturbances
52
What is a patient counseling point for Lovaza?
Take with food
53
What is the indication for Iscosapent Ethyl?
Hypertriglyceridemia
54
When is Icosapent Ethyl Preferred?
In patients with TGs >150 and need additional ASCVD risk lowering
55
What are the AEs of Icosapent Ethyl?
1. Hemorrhage 2. Musculoskeletal pain 3. Peripheral edema 4. Constipation 5. Gout
56
What are the DDIs of Icosapent Ethyl?
Anitplatelets and Anticoagulants
57
What is the patient counseling point of Icosapent Ethyl?
Swallow whole with food

Pharmacy Practice V (19 decks)

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