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Pharmacology 2 > Exam 2: Hyperlipidemia Drugs > Flashcards

Exam 2: Hyperlipidemia Drugs Flashcards

1
Q

What is the cause of Familial hypercholesterolemia?

A

LDL receptor deficiency

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2
Q

What are the 3 statin drugs?

A

Lovastatin, Simvastatin, and Atorvastatin

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3
Q

What is the MOA of statins?

A

Active forms are structural analogs of HMG-CoA reductase intermediate in mevalonate synthesis . Reduces plasma LDL by inhibiting the reductase to increased high affinity LDL receptor

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4
Q

What is the DOC to lower LDL?

A

Statins

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5
Q

What are the indications of statins?

A

To lower LDL, lower plasma TGs, and raise HDL

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6
Q

What are the other beneficial effects of statins that do not involve hyperlipidemia?

A
  • Decreased CRP in patients with CHD
  • enhance endothelial production of NO
  • Increase plaque stability
  • decrease lipoprotein oxidation
  • decrease platelet aggregation
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7
Q

Which statin is high intensity dosage used in high risk ASCVD patients?

A

Atorvastatin

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8
Q

Which two statins needs to be hydrolyzed to their active form and when should they be taken because of this?

A

Lovastatin and simvastatin

Take in the evenings

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9
Q

How are statins metabolized?

A

P450s

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10
Q

What are the adverse effects of statins?

A

Increased level of serum aminotransferases

  • May produce liver damage in alcoholics and patients with pre-existing liver problems
  • Myopathy and muscle pain
  • Increased serum CK
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11
Q

What are the contraindications of statins?

A
  • pregnancy
  • Active liver disease
  • P450 inhibitors or activators
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12
Q

What kind of drug is Cholestyramine?

A

Bile acid binding resin

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13
Q

What is the MOA of Cholestyramine?

A

Binding of bile acids prevent their intestinal reabsorption

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14
Q

What are the indications of Bile acid bindings resins?

A
  • elevated LDL
  • No effect in homozygous familial hypercholesterolemia because their is no functional LDL receptor
  • Not effective in hypertriglyceridemia (may increase VLDL)
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15
Q

What are the adverse effects of bile acid binding resins?

A
  • Constipation and bloating (most common)
  • Gallstones if obese
  • hypoprothrombinemia
  • may impair absorption of certain drugs
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16
Q

What drugs can bile acid resins inhibit absorption of?

A

Aspirin, Thyroxine, Tetracycline, Digitalis, statins, and thiazides

All Terrible Toddlers Demonstrate Scary Tantrums

17
Q

What is the MOA of Niacin?

A

Lowers plasma VLDL and LDL by inhibiting VLDL secretion

-also inhibits hepatic cholesterologenesis

18
Q

What are the indications of Niacin?

A
  • Increase clearance in the LPL pathway (decrease VLDL further)
  • increase levels of HDL
  • Most effective in hypercholesterolemia
19
Q

What kind of patients often receive Niacin?

A

Patients who cant exercise

20
Q

What are the adverse effects of Niacin?

A
  • generally mild
  • Cutaneous vasodilation, warm sensation, dry skin
  • Nausea, abd pain
  • increased ALT/AST, impairs glucose tolerate
  • Rarely hepatotoxicity
21
Q

What kind of drug is Gemfibrozil?

A

FIbric acid derivative

22
Q

What is the MOA of Gemfibrozil?

A

PPAR-alpha ligand, upregulates LPL and other genes involves in fatty acid oxidation

23
Q

What are the indications of Gemfibrozil?

A
  • Increases lipoprotein lipase activity
  • Decreases TGs
  • Decreases cholesterol
24
Q

What are the adverse effects of Gemfibrozil?

A
  • Increase incidence of Cholelithiasis and gallstones

- May increase LDL

25
Q

What is the MOA of Ezetimibe?

A

Selectively blocks intestinal absorption of cholesterol and relegated phytosterols

26
Q

What are the indications of Ezetimibe?

A
  • Moderate decrease in LDL ( no decrease in CV mortality)

- Needs to be combined with statin

27
Q

What kind of drugs Alirocumab and Evolocumab?

A

PCSK9 inhibitors

28
Q

What is the MOA of PCSK9 inhibitors?

A

Antibodies that inhibit PCSK9 from binding to LDLR.

29
Q

What are the indications of PCSK9 inhibitors?

A

-Increases LDLRs

30
Q

Gemfibrozil is most effective in what disease?

A

Hypertriglyceridemia

Pharmacology 2 (12 decks)

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