extra hepatic lipid modifiers

Question 1

Zetia

Answer 1

Ezetimibe, inhibits NPCL1 from transporting cholesterol from the lumen into brush border intestine
Lowers LDL
cholesterol absorption inhibitor

Question 2

Xenical

Answer 2

Orlistat, inhibits pancreatic lipase inhibiting absorption of dietary fat
fat absorption inhibitor

Question 3

Zetia ADME

Answer 3

Cholesterol Absorption Inhibitor
A: absorbed
D:systemic to limited degree 90% protein bound 
M: glucoronidated
E: feces

Question 4

Orlistat

Answer 4

Fat absorption inhibitor
A: stays in gut, no D, M,
E: feces

Question 5

Welchol

Answer 5

BETTER TOLERATED
Colesevelam upregs LDLR in liver by binding to - charge bile acid to be excreted in feces (prevent reabsorb cholesterol from bile)
Preferred in Pregnancy
Bile Acid resin

Question 6

Quetran

Answer 6

Cholestyramine upregs LDLR in liver by binding to - charge bile acid to be excreted in feces (prevent reabsorb cholesterol from bile)
Bile Acid resin

Question 7

Welchol ADME

Answer 7

Colesevelam no A or M, excreted in feces
can impair absorption fat soluble vitamins
Bile acid Resin

Question 8

Quetran ADME

Answer 8

Cholestyramine no A or M, excreted in feces
can impair absorption fat soluble vitamins
Bile acid Resin

Question 9

Niacin

Answer 9

inhibits lipolysis in adipose tissue> prevents liver from using FFA to make VLDL
NOT TOLERATED WELL (flushing, n/v)
MOST EFFECTIVE FOR HDL increase
decrease LDL and TG

Question 10

Niacin ADME

Answer 10

A- peak plasma 30-60min
D: broad systemic
M: rapid 1st pass
E- mostly urine, some feces

co therapy with statin increased risk myopathy

Question 11

Lopid

Answer 11

Gemfibrozil increases LPL activity (activates PPARalpha)
produce more HDL and LPL
can get myositis adverse event 
DECREASE TG (FIRST LINE PANCREATITIS)
fibrate

increased risk with statin MYOPATHY

Question 12

Tricor

Answer 12

Fenofibrate increases LPL activity (activates PPARalpha)
produce more HDL and LPL
can get myositis adverse event
DECREASE TG (FIRST LINE PANCREATITIS)
fibrate
increased risk with statin myopathy

Question 13

Clofibrate

Answer 13

dsctnd, adverse events especially with statin

fibrate

Question 14

fibrates ADME

Answer 14

A; peak plasma 1-2hrs
D; broad systemic, plasma bound
M; rapid first pass, glucoronidated
E; major glucoronidated urine

Question 15

Juxtapid

Answer 15

Lopitamide is MTTPI which inhibits transfer of TG to intestinal and liver cells
metabolized by CYP3A4