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Pharmacology Exam 2 > Hyperlipidemia > Flashcards

Hyperlipidemia Flashcards

1
Q

Optimal LDL

A

<100

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2
Q

Near optimal LDL

A

100 – 129

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3
Q

Borderline LDL

A

130 – 159

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4
Q

High LDL

A

160 – 189

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5
Q

Very high LDL

A

> 190

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6
Q

TGL Ideal

A

<150

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7
Q

Desirable total cholesterol

A

< 200

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8
Q

Borderline total cholesterol

A

200 – 239

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9
Q

High total cholesterol

A

> 240

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10
Q

Low HDL

A

<40

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11
Q

High HDL

A

> 60

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12
Q

Lipoprotein (a)

A

Modified form of LDL.
Impairs fibrinolysis, promotes deposition of cholesterol in arthrosclerotic plaques.
Routine screening not recommended.
Decrease with Niacin.

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13
Q

Homocysteine

A

Amino acid, has athrogenic and prothrombotic effects.
Routine screening not recommended.
Decrease with Folate, B6 & B12.

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14
Q

Clinical Atherosclerotic Cardiovascular Disease (ASCVD)

A

Age ≤ 75: high-intensity statin

Age > 75 OR not candidate for high-intensity statin: moderate-intensity statin

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15
Q

LDL-C ≥ 190 mg/dl

A

Evaluate for secondary causes of hyperlipidemia
High-intensity statin (moderate-intensity if not candidate for high-intensity statin)
May add non-statin if needed to further lower LDL-C

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16
Q

Age 40 – 75 with diabetes

A

Moderate intensity statin (high intensity if≥ 7.5% 10-yr ASCVD risk)
Weigh individual risks and benefits for older or younger patients

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17
Q

≥ 7.5% 10-year ASCVD risk and age 40 – 75

A

Moderate to high intensity statin

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18
Q

High Intensity Statin

A

Lowers LDL-C by >/= 50%

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19
Q

Moderate Intensity Statin

A

Lowers LDL-C by 30-50%

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20
Q

Low Intensity Statin

A

Lowers LDL-C by <30%

21
Q

Atorvastatin (Lipitor)

A

40-80 mg

High Intensity Statin

22
Q

Rosuvastatin (Crestor)

A

20-40 mg

High Intensity Statin

23
Q

Atorvastatin (Lipitor)

A

10-20 mg

Medium Intensity Statin

24
Q

Rosuvastatin (Crestor)

A

5-10 mg

Medium Intensity Statin

25
Q

Simvastatin (Zocor)

A

20-40 mg
Medium Intensity Statin
NOT with itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, nefazodone, gemfibrozil, cyclosporine, danazol.
NO more than 20 mg with amlodipine

26
Q

Pravastatin (Pravachol)

A

40-80 mg

Medium Intensity Statin

27
Q

Lovastatin (Mevacor)

A

40 mg

Medium Intensity Statin

28
Q

Fluvastatin XL (Lescol XL)

A

80 mg

Medium Intensity Statin

29
Q

Fluvastatin BID

A

40 mg

Medium Intensity Statin

30
Q

Pitavastatin (Livalo)

A

2-4 mg

Medium Intensity Statin

31
Q

Simvastatin (Zocor)

A

10 mg
Low Intensity Statin
NOT with itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, nefazodone, gemfibrozil, cyclosporine, danazol.
NO more than 10 mg with amiodarone, verapamil, diltiazem.

32
Q

Lovastatin (Mevacor)

A

20 mg

Low Intensity Statin

33
Q

Fluvastatin BID

A

20-40 mg

Low Intensity Statin

34
Q

Pitavastatin (Livalo)

A

1 mg

Low Intensity Statin

35
Q

Statins are Pregnancy Category __

A

X

36
Q

Before starting statin therapy and monitoring on statins

A

Baseline ALT
Baseline CK for patients at increased risk for adverse muscle events
Liver functions or CK during statin therapy for symptoms
Evaluate for diabetes according to recommended screening
Evaluate for other source of muscle pain if occurs
Evaluate for other causes of confusion or memory impairment if occur

37
Q

Hypertriglyceridemia

A

Recommend fibric acids first line
Nicotinic acid or Omega-3 fatty acids next
Avoid bile acid sequestrants (elevate TG)

38
Q

HMG-CoA Reductase Inhibitors (Statins)

A

Block conversion of HMG-CoA to mevalonate, thereby limiting the rate of production of cholesterol in the liver. .
Adverse effects:
Myopathy, myalgias
Increased liver enzymes
Contraindicated with liver disease, caution with heavy alcohol use
Drug interactions (CYP system)

39
Q

Bile Acid Resins (Bile Acid Sequestrants)

A

Decreases return of cholesterol to liver by binding bile acids into an insoluble compound that is excreted in the feces.
Increased LDL receptors on liver
Decrease serum LDL, but will increase VLDL & triglyceride level.
Best for moderated elevated LDL and low CVD risk
Do not use if TG >200 – 400.
May be given along with statins.
GI side effects.
Give other meds at least 1 hour before or 4 hours after
Often used for women who are pregnant or who may become pregnant

40
Q

Niacin (Nicotinic Acid)

A

Unknown MOA.
Decreases VLDL synthesis in liver.
Avoid in liver disease, PUD, arterial bleeding.
Can increase glucose, PT, uric acid,
Cn decrease phosphorus, platelets.
Causes flushing and itching of the neck and face (325 mg of Aspirin 30 minutes before dose may help).

41
Q

Cholesterol Absorption Inhibitors

A

Works on brush border of small intestine decreasing absorption of cholesterol and decreasing delivery to liver. Reduces stores in liver and increases clearance of cholesterol from the blood.

42
Q

Fibric Acid Derivatives

A

Unclear MOA.
Stimulation of lipoprotein lipase enhances breakdown of VLDL to LDL.
May inhibit hepatic VLDL production.
Effective triglyceride lowering drug.
Modestly lower LDL. Raise HDL.
Do not use with severe renal or .hepatic disease
Watch for gallstones, myopathy
Caution with anticoagulants (and fenofibrates).
Gemfibrozil can NOT be added to a statin.
GI side effect.

43
Q

Omega-3 Fatty Acids

A

May reduce VLDL-TGL synthesis and/or secretion from liver.
May enhance TGL clearance from circulating VLDL.
Indicated for reduction of TG in adults with severe hypertriglyceridemia (>500 mg/dl).
May elevate LDL.
Monitor liver enzymes.
Lovaza has warning about atrial fib/flutter.
Can add to a statin.

44
Q

Cholestyramine (Questran)

A

Bile Acid Resins (Bile Acid Sequestrants)

45
Q

Cilesevelam (Welchol)

A

Bile Acid Resins (Bile Acid Sequestrants)

46
Q

Colestipol (Colestid)

A

Bile Acid Resins (Bile Acid Sequestrants)

47
Q

Ezetamide (Zetia)

A

Only Cholesterol Absorption Inhibitor on market

48
Q

Fenofibrate (Tricor, Trilipix)

A

Fibric Acid Derivative

49
Q

Gemfibrozil (Lopid)

A

Fibric Acid Derivative

Pharmacology Exam 2 (11 decks)

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