dyslipiedemia drugs

Question 1

what are dyslipidemic drugs used for?

Answer 1

to decrease blood lipids
prevent or delay the dev of atherosclerotic plaque
promote the regression of existing atherosclerotic plaque
reduce morbidity and mortality from cardiovascular disease

Question 2

what is the total normal serum cholesterol?

Answer 2

<5.2nmol/L

Question 3

what are HMG CCoA Reductase Inhibitors (Statins)

Answer 3

drugs that inhibit an ezyme required for hepatic synethsis of cholesterol

decrease total serum cholesterol, LDL, VLDL, and triglycerides

Question 4

what is the most effective anti-lipedimic? ***

Answer 4

what are HMG CCoA Reductase Inhibitors (Statins)

Question 5

what do statins do to HDLs?

Answer 5

remain unchanged or may increase

Question 6

what do statins do to C-reactive protein?

Answer 6

reduce it associated with MI and stroke

Question 7

when do you take a statin?

Answer 7

bedtime because produce most amount of lipids at night

Question 8

what are some adverse effects of statins? ***

Answer 8

Hepatotoxicity, as evidenced by increase in aspartate transaminase (AST) (i.e. no statins with liver disease)

Myopathy, as evidenced by muscle aches, pain, and tenderness, may progress to myositis or rhabdomyolysis

Peripheral neuropathy, as evidenced by weakness, numbness, tingling, and pain in the hands and feet

Question 9

medication and food interactions of statins? **

Answer 9

fibratates (gemfibrozil, fenofibrate) and ezetimibe inc the risk of myopathy

meds that suppress Cyp3A4 such as erythromycin and ketoconazole, can inc levels of statins when taken concurrently

grapefruit juice suppress CYP3A4 and can inc levels of statins

Question 10

whats an example of a bile acid sequestrant?

Answer 10

cholestyramine (questran)

Question 11

what do bile acid sequestrants (like cholestryamine) do?

Answer 11

bind bile acids in the intestinal lumen… loss of bile acid stimulates hepatic synethsis of more bile acids from cholesterol, reducing serum cholesterol, especially DL

Question 12

what would bile acid sequestrants may be combined with?

Answer 12

statins to further reduce LDL

Question 13

what are some AE for bile acid sequestrants?

Answer 13

I discomfort, constipation, and diarrhea, may cause gallstones ***

Question 14

example of fibrate?

Answer 14

fenofibrate (lipidil)

Question 15

what do fibrates do?

Answer 15

Increase the oxidation of fatty acids in liver and muscle tissue, decreasing hepatic production of triglycerides, VLDL, and increase HDL

Question 16

which drug is the most effective for reducing serum triglycerides?

Answer 16

fibrates

Question 17

fibrates may cause ___

Answer 17

gallstones

Question 18

AE of fibrates?

Answer 18

GI discomfort, prolonged PTT, hot flash feeling

Question 19

what drug dose must be reduced for fibrates???

Answer 19

***warfarin

Question 20

what is niacin also known as?

Answer 20

vitamin b3

Question 21

what does niacin do?

Answer 21

decreases cholesterol and triglycerides by inhibiting mobilization of free fatty acids frm peripheral tissues

Question 22

what is the most effective drug for increasing HDL?

Answer 22

niacin

Question 23

high doses of niacin cause what?

Answer 23

skin flushing, pruiritis, and gastric irritation ***

**may also cause hyperglycemia, hyperuricemia, elevated liver enzymes and hepatitis

Question 24

example of cholesterol absorption inhibitor ?

Answer 24

ezetimibe (ezetrol)

Question 25

what do cholesterol absorption inhibitors do?

Answer 25

Only agent in the newest class of dyslipidemic drugs
Reduces total cholesterol and triglycerides
not covered by BC PharmaCare, not carried by IH ->
BC ministry of Health determined it was not better or safer than statins
Expensive (30 day supply 218 US$)

Question 26

what are some natural health products used for dec lipids?

Answer 26

Absorption of medication may be reduced with use of flax or flax seed
Garlic has little scientific support for use as dyslipidemic agent
Green tea is used as dyslipidemic, but caffeine may be CNS stimulant
Soy has been researched extensively as dyslipidemic, no big changes in LDL/HDL seen