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Pharm II > Hyperlipidemia > Flashcards

Hyperlipidemia Flashcards

1
Q

First line tx for hyperlipidemia?

A

Lifestyle modification

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2
Q

What disease has an LDL receptor deficiency (due to gene mutation) leading to increased levels of LDLs?

A

Familiar hypercholesterolemia

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3
Q

Why do you chest cholesterol levels after pt has undergone weight loss and not during their weight loss?

A

B/c cholesterol levels are low during weight loss and stabilize for one month after

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4
Q

Lovastatin, Simivastatin, Atorvastatin are what dug class?

A

HMG-CoA Reductase inhibitors

-statins

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5
Q

MOA for Lovastatin, Simivastatin, Atorvastatin?

A

Inhibit HMG-CoA reductase to increase high affinity LDL receptors (more LDL into cells to reduce serum LDL levels)

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6
Q

DOC for lowering LDLs?

A

Statins (most effective when LDL is elevated)

Also lower TGs and increase HDL and stabilize plaques

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7
Q

What size dose of Atorvastatin do you give in high risk in atherosclerosis CVD pts?

A

High dose (stabilize plaques)

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8
Q

What two statin drugs are pro drugs?

A

Lovastatin and simvastatin

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9
Q

What drug class interacts w/ P450s-CYP3A4?

A

Statins

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10
Q

At what time of day should statins be taken?

A

Before bed (peak cholesterol synthesis at night)

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11
Q

What can Atorvastatin be taken at anytime of day?

A

Longer half life

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12
Q

What drug class increases serum levels of aminotransferase (LFTs)?

A

Stains (metabolized in liver)

May cause liver damage in pts w/ established liver disease or alcoholics

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13
Q

Myopathy, increased serum creatine kinase (due to exercise) and rhabdomyolysis are adverse effects of what drug class?

A

Statins

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14
Q

What two populations are statins contraindicated?

A

Pregnant, Active liver disease

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15
Q

Do P450 inhibitors increase or decrease plasma concentration of statins?

A

Increase

EX: grapefruit, ,macrolides, ketoconazole, ritonavir

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16
Q

Do P450 activators increase or decrease plasm concentration so statins?

A

Decrease

EX: Barbiturates, Rifampin, griseofulvin, phenytoin

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17
Q

Cholestyramine is what class of meds?

A

Bile acid binding resins

18
Q

MOA for Cholestyramine?

A

Bind bile acids and prevent their intestinal reabsorption (increased LDL receptors –> increased LDL absorption –> decreased LDL levels

19
Q

Does cholestyramine have any effect on homozygous familial hypercholesterolemia?

A

No

20
Q

What makes Cholestyramine a safe drug?

A

It is not absorbed by the body.

Safe in pregnancy

21
Q

When should cholestyramine be taken?

A

With meals b/c needs bile production to be effective

22
Q

Most common side effects of Cholestyramine?

A

Bloating and constipation

23
Q

Cholestyramine may impair the absorption of what drugs?

A

Acids or fat soluble drugs like: Digitalis, thiazides, statins, tetracylines, thyroxine, aspirin

24
Q

What is the MOA for Niacin?

A

Lowers plasma VLDL and LDL by inhibiting VLDL secretion

Also inhibits hepatic cholesterolgenesis

25
Q

Niacin is a combo of what?

A

nicotinic acid and Vit. B3

26
Q

Will Niacin increase or decrease levels of HDL?

A

Increase (most effective agent to do so)

- Used in pts who can’t exercise

27
Q

Cutaneous vasodilation, feeliing like “on fire” is a side effect of what drug?

A

Niacin

TX w/ prostaglandin aspirin beforehand

28
Q

Why should Niacin be avoided in DM pts?

A

Impairs glucose tolerance

29
Q

Gemfibrozil is what drug class?

A

Fibric acid derivative

30
Q

MOA for Gemfibrozil?

A

Up regulates lipoprotein lipase activity (increases catabolism of VLDL) and turns on genes to involved in fatty acid oxidation via nuclear receptor

31
Q

What does Gemofibrozil lower?

A

VLDLs, TGs, Cholesterol

32
Q

DOC for hypertriglyceridemia?

A

Gemfibrozil (fibrates)

33
Q

What meds will increase LFTs and incidence of cholelithiasis/gallstones?

A

Gemfibrozil (fibrates)

34
Q

What class of drugs lowers LDLs the most?

A

Statins (HMG-CoA reductase inhibitors)

35
Q

What drug blocks intestinal absorption of cholesterol?

A

Ezetimibe

36
Q

What drug has no effect on CV endpoints?

A

Ezetimibe

37
Q

Ezetimibe is often combinesdwith what drug for synergistic effects?

A

Statins

Ezetimibe can only be used in combo therapy

38
Q

Alirocumab and Evolocumab are what drug class?

A

PCSK9 Inhibitors

39
Q

MOA for Alirocumab and Evolocumab

A

Antibodies that inhibit PCSK9 from binding to LDL Receptor

PCSK9 binds to LDLR on hepatocyte surface –> LDLR degradation

40
Q

How are Alirocumab and Evolocumab administered?

A

Monthly subQ injections

Pharm II (13 decks)

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