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Pharmacology > Exam 6 - Drugs for Hyperlipidemia > Flashcards

Exam 6 - Drugs for Hyperlipidemia Flashcards

1
Q

LDL and non-HDL goal for a person of lower risk: 0-1 risk factors

A

LDL goal: <160

non-HDL goal: 190

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2
Q

What is the only way to raise your HDL?

A

exercise; has no effect on LDL but increases HDL by 4-22%

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3
Q

Statins: MOA

A

HMG-CoA Reductase inhibitors

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4
Q

Do not use 80 mg dose

A

Simvastatin

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5
Q

As a group, what are statins the drug of choice for?

A

LDL reduction

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6
Q

Metabolized by 3A4

A

Atorvastatin
Lovastatin
Simvastatin

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7
Q

Metabolized by 2C9

A

Rosuvastatin

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8
Q

Statin adverse effects

A
  • Elevation in liver enzymes
  • Myopathy (myalgia, myositis, rhabdomyolysis)
  • cognitive dysfunction (age>50)
  • elevated blood glucose/diabetes
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9
Q

Complaints of muscle pain or weakness w/o elevation in creatine kinase (CK), marker for muscle damage

A

Myalgia

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10
Q

Complaints of muscle aches/pains w/ mildly elevated CK levels (<10 times the ULN)

A

Myositis

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11
Q

Complaints of muscle pain w/ presence of dark urine and a CK level > 10 times the ULN

A

Rhabdomyolysis

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12
Q

Drug interactions of Statins: potentiate the risk of myopathy/rhabdomyolysis

A
  • Amidarone
  • Azole antifungal agents
  • Macrolide antibiotics
  • Verapamil
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13
Q

Cholestyramine

A

Bile acid sequestrant

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14
Q

Colesevelam (Welchol)

A

Bile acid sequestrant

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15
Q

Cholestyramine and Colesevalam/Wilchol are both indicated for

A

Hypercholesteremia

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16
Q

Indicated for diarrhea and pruritis associated w/ partial biliary obstruction.

A

Cholestyramine

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17
Q

Indicated to improve glycemic control in adults w/ Type II diabetes mellitus

A

Colesevelam (Welchol)

18
Q

interrupts the enterohepatic circulation of bile acids which depletes cholesterol content of hepatic cells

A

Bile acid sequestrants MOA

19
Q

Bile acid sequestrant: adverse effects

A
  • constipation
  • abdominal pain
  • bloating
  • dyspepsia (indigestion)
  • flatulence
  • INCREASES TG (TG>400 mg/dL contraindicated)
20
Q

Bile acid sequestrant: drug ineractions

What do these drugs decrease the absorption of?

A
  • warfarin
  • levothyroxine
  • digoxin
  • thiazide diuretics
21
Q

When should other medications be taken when taken bile acid sequestrants?

A

other medications should be taken at least 1 hour before or 4 hours after the bile sequestrant

22
Q

Inhibits intestinal absorption of dietary and biliary cholesterol at the brush border of the small intestine

A

Ezetimibe

23
Q

Ezetemibe: adverse effects

A
  • GI: diarrhea, abdominal pain

- increase in ATL

24
Q

Gemfibrozil

A

Fibrate

25
Q

Fenofibrate

A

Fibrate

26
Q

Fibrates: adverse effects

A
  • abdominal pain, INCREASE IN GALLSTONES
  • MYALGIA, MYOPATHY
  • increase in serum creatinine
27
Q

Activates peroxisome proliferator activator - alpha (PRAR-alpha) which enhances catabolism (by LIPOPROTEIN LIPASE) of triglycerides and decrease hepatic synthesis of VLDL particles and increases HDL levels

A

Fibrates MOA

28
Q

Fibrates contraindications

A
  • severe hepatic disease
  • SEVERE RENAL DISEASE (DO NOT USE FENOFIBRATE)
  • PREEXSITING GALLBLADDER DISEASE
29
Q

Gemfibrozil drug interaction

A
  • CONTRAINDICATED: INCREASES REPAGLINIDE LEVELS (HYPERGLYCEMIA)
  • increases statin levels (muscle toxicity)
30
Q

Fenofibrate drug interaction

A

has minimal impact on statin levels

31
Q

Enhance lipoprotein lipase

A

Niacin MOA

32
Q

Niacin adverse effects

A
  • GI (nausea, exacerbation of peptic ulcers)
  • flushing, pruritus
  • liver dysfunction (liver enzyme abnormalities)
  • glucose intolerance (hyperglycemia)
  • hyperuricemia/gout
  • peptic ulcer disease
33
Q

Niacin contradindications

A
  • significant hepatic dysfunction
  • active peptic ulcer disease
  • gout
34
Q

Indicated to treat hypertriglyceridemia > 500 mg/dL

A

Omega-3-acid ethyl esters

35
Q

Indicated for high TG (> or equal to 500 mg/dL)

A

Icosapent ethyl

36
Q

Icosapent ethyl

A

may prolong bleeding time

37
Q

What should you monitor when giving Icosapent ethyl?

A

LFT (patients w/ hepatic impairment), lipids

38
Q

Moderate risk: 2+ riskfactors

10-year risk < 10%

A

LDL goal: < 130

non-HDL goal: <160

39
Q

High risk: CHD or CHDrisk equivalents

10-year risk >20

A

LDL goal: <160

40
Q

Moderate high risk: 2+ risk equivalents

10-year risk 10%-20%

A

LDL goal: <160

41
Q

Use caution in patients w/ known hypersensitivity to fish and/or shellfish

A

Icosapent ethyl

42
Q

What do omega-3 ethyl esters contain that icosapent ethyl doesn’t? And what does it cause?

A
  • contains DHA

- causes an increase in LDL

Pharmacology (19 decks)

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