E1-LowerCholesterol (Anti-Lipidemics)

Question 1

old class of medications = not used much anymore

Answer 1

Bile Acid Sequestrants

Question 2

Bile Acid Sequestrants reduce cholesterol by binding to _______ in the gut

Answer 2

binding bile acids in gut

Question 3

Bile Acid Sequestrants: increase fecal loss of bile salt bound ____ cholesterol

Answer 3

LDL

Question 4

What are all the Bile Acid Sequestrants named with? What are three of them?

Answer 4

“cole-/chole”….1.CHOLES-TYR-AMINE resin 2.COLE-SEVE-Lan 3.COLE-sti-pol

Question 5

Nicotinic Acid (Niacin) decreases liver triacylglycerol synthesis necessary for _____ production AND IN TURN decreased these decreases plasma ______

Answer 5

VLDL….LDLs

Question 6

Nicotinic Acid (Niacin)can _______ some endothelial cell dysfunction leading to thrombosis caused by high cholesterol and atherosclerosis

Answer 6

reverse!!!

Question 7

What is the least expensive Cholesterol med?

Answer 7

Nicotinic Acid (Niacin)

Question 8

What is the most common/known side effect with Niacin?

Answer 8

Facial Flushing

Question 9

Fibric Acids-lowers plasma ________

Answer 9

triglycerides

Question 10

Fibric Acids-increases _____’s

Answer 10

HDL’s

Question 11

Fibric Acids-inhibit _______ synthesis in liver

Answer 11

cholesterol

Question 12

What are the 3 preparations of FIBRIC ACIDS?

Answer 12

1.Clo-FIBR-ate 2.feno-FIBR-ate 3.gem-FIBR-ozil

Question 13

HMG CoA Reductase Inhibitors aka “______”

Answer 13

“statins”

Question 14

What is the LEADING cholesterol-lowering medication?

Answer 14

Statins! (HMG CoA Reductase Inhibitors)

Question 15

What are the two methods which HMG CoA Reductase Inhibitors (statins) lower cholesterol??? What is the NEW EVIDENCE of ANOTHER positive effect of statins???

Answer 15

1. decreases synthesis of cholesterol in liver 2. increases LDL breakdown….NEW–anti-inflammatory activity!!

Question 16

What is the MAIN contraindication with STATINS?

Answer 16

LIVER DISEASE! elevated liver enzymes mean discontinue the drug

Question 17

What is the main SIDE EFFECT of statins?? (2 names for 1 condition)…Where do Pts complain of this symptom?

Answer 17

MYALGIA-rhabdomyolysis (a disease characterized by the disintegration of the muscle tissue)….lower extremities

Question 18

IMPORTANT DENTAL DRUG INTERACTION= RED FLAG DRUGS…Avoid use of _________ antibiotics (like ________) and systemic (_____) antifungal medications in statin users: promotes _________

Answer 18

macrolide (erythromycin)… azole… RHAB-DO-MYO-LYSIS

Question 19

Which cholesterol lowering drug is the ONLY one in its class that decreases intestinal cholesterol absorption???

Answer 19

EZ-ET-imi-be

Question 20

What are the two drugs that add a statin and EZ-ET-imi-be??

Answer 20

1.Vy-tor-in 2.Lip-tru-zet

Question 21

Statin indications: 21 years and older who have a very high level of bad cholesterol (_____ mg/dL or higher) AND with _________ who are 40 to 75 years old

Answer 21

190mg/dL….Type 1 or Type 2 diabetes

Question 22

Statin indications/use: The guidelines also advise doctors to no longer prescribe additional cholesterol-lowering drugs, such as fibrates and niacin, to patients who do not reach targets with statins alone. AND a healthy ______ should always be a part of the therapy.

Answer 22

lifestyle

Question 23

WHEELHOUSE!!!! Oral Care Considerations with Lipid Lowering Agents–multiple drug __________: look up each medication before prescribing dental meds

Answer 23

interactions

Question 24

WHEELHOUSE!!!! Oral Care Considerations with Lipid Lowering Agents–assess risk for increased _______

Answer 24

BLEEDING

Question 25

WHEELHOUSE!!!! Oral Care Considerations with Lipid Lowering Agents–avoid _______ and ________ with HMG CoA Reductase Inhibitors

Answer 25

azole antifungals…macrolide antibiotics

Question 26

WHEELHOUSE!!!! Oral Care Considerations with Lipid Lowering Agents–assess changes in cholesterol lowering medications at each visit (frequently change due to ______ issues)

Answer 26

COMPLIANCE