Fibric acid derivaties and Niacin

Question 1

Drugs

Answer 1

Clofibrate
Gemifibrozil
Fenofibrate

Question 2

M.O.A

Answer 2

Activates PPAR-a -> Regulates gene transcription -> decrease TG & LDL-C - increase HDL-C

Question 3

Effects

Answer 3

• Mediate expression of lipoprotein lipase
• Catalyze hydrolysis & removal of TG from VLDL
• Decrease expression of apolipoprotein C
• Decrease Expression enzyme oxidizing fatty acids
• Mediate expression of A-1 & A2
• Increase expression of cholesterol transport proteins

Question 4

Indications

Answer 4

• Prevent Pancreatitis (very high TG levels)
• Reduce risk CHD
• Lipidemia - not improved by life changes and drugs

Question 5

Adverse Effects

Answer 5

G.I - Most common

Blood cell deficiencies
Hypersensitivity

Myopathy & Rhabdomyolysis - Avoid w/statins

Question 6

Niacin (Vitamin B3) - M.O.A

Answer 6

Inhibits formation & secretion hepatic VLDL
G protein - coupled receptor binding
-> - Decreased LDL-C,
- Lipoprotein (a) (consistet decrease, only niacin)
- Decrease TG
- Increased HDL-C & HDL2

Question 7

Niacin - Indications

Answer 7

Primary hyperlipidemia
Mixed dyslipidemia
Reduce risk pancreatitis(very high TG)
Reduce risk M.I - Men w/H.cholesterolemia & atherosclerosis

Question 8

Niacin - Adverse

Answer 8

High doses:
Flushed skin
Pruritus
(Pretreatment w/aspirin or adm sustained release prep)

Hepatitis
Hyperuricemia & Gout

Gi distress - aggravate PUD
Increased blood glucose - Aggravate DM