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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
Q

What are the indications for Fenofibrate?

A

Hypercholesterolemia and Hypertriglyceridemia

26
Q

What are the DDIs when using Fenofibrate?

A
  1. Warfarin
  2. Statins
27
Q

What are the CI’s for Fenofibrate?

A
  1. Acute Liver Disease
  2. Severe Renal Impairment or End Stage Renal Disease
  3. Gallbladder Disease
28
Q

When should you avoid the use of Fenofibrate?

A

CrCl <30

29
Q

What are the warnings for Fenofibrate?

A
  1. Cholelithiasis
  2. Increased LFTs
  3. Myopathy/Rhabdo
  4. Pancreatitis
  5. VTE
30
Q

What are the BAS Medications?

A

Cholestyramine and Colesevelam

31
Q

What are the warnings for ALL BAS meds?

A
  1. AVOID with GI motility problems
  2. AVOID with hypertriglyceridemia >300/500
  3. History of Pancreatitis
32
Q

What are counseling points for BAS meds?

A
  1. Give with ample fluids
  2. Take with meals
  3. Take other meds 1 hr before or 4 hrs after
33
Q

What is the indication for Cholestyramine?

A

Dyslipidemia

34
Q

What are the DDIs and CI of Cholestryramine?

A

DDI: reduces absorption of many drugs
CI: Complete biliary obstruction

35
Q

What are the AEs of Cholestryamine?

A

Constipation, N/V

36
Q

What is the indication for Colesevelam?

A

Hyperlipidemia, Type 2 DM

37
Q

What are the CIs for Colesevelam?

A
  1. History of bowel obstruction
  2. Serum TG > 500 mg/dL
  3. History of hypertriglyceridemia induced pancreatitis
38
Q

What are the AEs of Colesevelam?

A

Constipation, Dyspepsia, and HA

39
Q

What is the indication of Niacin?

A

Dyslipidemia (Hypertriglyceridemia)

40
Q

What are the DDIs of Niacin?

A

Statins

41
Q

What are the CIs of Niacin?

A
  1. Hepatic Dysfunction of Elevated LFTs
  2. Active peptic ulcer
  3. Arterial Hemorrhage
42
Q

What are the AEs of Niacin?

A
  1. Flushing
  2. Pruritus
  3. Rash
  4. GI: vomit, diarrhea
43
Q

What are the patient counseling points of Niacin?

A
  1. Admin HS with snack
  2. Premedicate with ASA or NSAID for flushing
  3. Alcohol or Spicy food may intensify flushing
44
Q

What is the indication of Ezetimibe?

A

Primary Hyperlipidemia

45
Q

What are the DDIs for Ezetimibe?

A
  1. Fibric acids can increase Cp
  2. BAS decrease Cp
  3. Do NOT use with Gemfibrozil
46
Q

What are the patient counseling points of Ezetimibe?

A
  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
Q

What is Vytorin?

A

Simvastatin + Ezetimibe

48
Q

What is the indication for Lovaza?

A

Hypertriglyceridemia, adjunct to reduce triglycerides in adults with levels >500

49
Q

What are the DDIs for Lovaza?

A
  1. Antiplatelets
  2. Anticoagulants
50
Q

What are the cautions of Lovaza?

A

Fish Allergy
Prolongation of Bleeding Time

51
Q

What are the AEs of Lovaza?

A
  1. Belching
  2. Dyspepsia
  3. Diarrhea
  4. Taste Disturbances
52
Q

What is a patient counseling point for Lovaza?

A

Take with food

53
Q

What is the indication for Iscosapent Ethyl?

A

Hypertriglyceridemia

54
Q

When is Icosapent Ethyl Preferred?

A

In patients with TGs >150 and need additional ASCVD risk lowering

55
Q

What are the AEs of Icosapent Ethyl?

A
  1. Hemorrhage
  2. Musculoskeletal pain
  3. Peripheral edema
  4. Constipation
  5. Gout
56
Q

What are the DDIs of Icosapent Ethyl?

A

Anitplatelets and Anticoagulants

57
Q

What is the patient counseling point of Icosapent Ethyl?

A

Swallow whole with food

Pharmacy Practice V (19 decks)

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