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Advanced Pharm > Hyperlipidemia > Flashcards

Hyperlipidemia Flashcards

1
Q

What is the initial therapy for treatment of hyperlipidemia?

A

Lifestyle modifications

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2
Q

What is the first line drug therapy for hyperlipidemia?

A

HMG-CoA reductase inhibitors

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3
Q

What is the other name for the HMG-CoA reductase inhibitors?

A

Statins

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4
Q

What is the mechanism of action of statins?

A

They inhibit HMG-CoA reductase that is an enzyme that helps produce liver synthesis of cholesterol. By inhibiting the enzyme, the liver decreases synthesis cholesterol and increases cholesterol receptors and uptake of LDL-C. Statins can also help promote the decrease in atherosclerotic plaques through LDL-C reuptake

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5
Q

What are the common side effects of statins?

A

headache, rash, GI disturbances

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6
Q

What are adverse effects of statins?

A

Myopathy and rhabdo, hepatotoxicity, new-onset diabetes, reversible memory loss

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7
Q

What is a common education piece for patients on statins

A

Teaching about the S&S of myopathy

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8
Q

What is a lab value other than lipid panel you should monitor in patients on a statin?

A

LFTs d/t the ADR of hepatotoxicity

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9
Q

What is the category risk in pregnancy for statins?

A

Category X

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10
Q

What is the effect on LDL-C from statins?

A

% reduction is based on statin intensity

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11
Q

What food should patients on statins avoid?

A

Grapefruit d/t the CYP3A4 inhibition thus raising statin levels

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12
Q

When should follow up lipid panels be drawn?

A

6-8 weeks after initiation of therapy for adjustment

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13
Q

How often should we follow up with patients on statins?

A

6-8 weeks until at goal, then 8-12 weeks for the first year

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14
Q

What is the mechanism of action of the bile-acid sequestrants?

A

Prevent reabsorption of the bile acids by binding to the bile acids when excreted into the GI tract thus increasing the need for LDL-C uptake to promote the production of bile acids in the liver

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15
Q

What are common side effects of bile-acid sequestrants?

A

GI disturbances

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16
Q

What is the most common bile-acid sequestrant?

A

Colesevelam

17
Q

What is a common drug interaction with bile-acid sequestrant?

A

They can bind to other medications, thus rendering them ineffective by preventing their absorption. Take medications 1 hour prior to or 4 hours after

18
Q

What is the mechanism of action of niacin?

A

inhibits free fatty acid absorption in the tissues, inhibits cAMP and reduces VLDL and LDLs

19
Q

Why is niacin not used as much anymore?

A

It has increased cardiovascular risks such as stroke

20
Q

What is the most common medication used as a second line therapy with statins?

A

Ezetimibe (Zetia)

21
Q

What is the mechanism of action of Zetia?

A

Inhibits dietary cholesterol absorption and inhibits reabsorption of cholesterol secreted in bile

22
Q

What is a severe adverse effect of Zetia?

A

Gallstones

23
Q

What are other side effects of Zetia?

A

Myopathy/Rhabdo, pancreatitis, hepatitis, thrombocytopenia

24
Q

When is Zetia contraindicated?

A

Hepatic impairment as it can increase bioavailability

25
Q

What is the mechanism of action of the PCSK-9 Inhibitors?

A

Binds to and inhibits the PCSK-9 enzyme to free LDL receptors to promote LDL-C reduction

26
Q

What are the side effects of the PCSK-9’s?

A

hypersensitivity reactions and immunogenicity due to the development of antibodies

27
Q

When are the PCSK-9 indicated for use?

A

When patients are adherent to lifestyle modifications and on maximal stain therapy

28
Q

What is the mechanism of action for fibrates?

A

Inhibits cholesterol and triglyceride synthesis thus decreasing VLDL and LDL production and levels in the body

29
Q

What is the side effects of fibrates?

A

N/V/D, rash, abdominal pain, gallstones

30
Q

What medications are fibrates contraindicated with use?

A

Zetia as both increase the risk for gallstones

31
Q

What medications are fibrates cautioned with?

A

Warfarin as it displaces warfarin from plasma albumin and can increase free warfarin levels and increase anticoagulabiity
Statins as the two can increase myopathy risk

32
Q

What is an OTC treatment for hyperlipidemia?

A

Omega-3 Fish oil, CoQ-10

Advanced Pharm (15 decks)

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