Hyperlipidemia and Prostaglandins Flashcards
Raises TG and VLDL?
Alcohol
Hyperchylomicronemia associated with?
Acute pancreatitis
Reversible HMG Coa reductase inhibitor?
Simvastatin
“Simple lang to reverse”
MOA of simvastatin?
Decrease cholesterol synthesis
Increase LDL uptake in the liver by inc LDL receptors
Overall dec LDL levels
Why are statins used in ACS?
Stabilize plaque
Simvastatin AE?
Hepatotox.
GI distress.
Myopathy.
Rhabdomyolysis.
Statins Enhance risk of rhabdo and myopathy if given with?
Fibrates
When is the peak of cholesterol synthesis?
At night. Give statins ODHS.
How much of bile acids are reabsorbed? Returned back to?
90%
Enterohepatic circulation
Bile acid binding resin for hypercholesterolemia and pruritus in cholestasis?
Cholestyramine
Also for digitalis toxicity
AE Cholestyramine?
Constipation. Bloating. Gritty taste. Steatorrhea. Malabsorption.
Treat cholestyramine-induced constipation with?
Fiber supplements
Psyllium
MOA of bile acid binding resins?
Bind bile acids
Prevent reabsorption, increase use of hepatic cholesterol to synthesize new bile acid
Effect of BABR on LDL TG VLDL?
Modest decrease in LDL
Little or no effect on TG and VLDL
Where is cholesterol absorbed?
Jejunum
Via NPC1L1 transporter
Same transporter for physosterol
Selective inhibitor of NPC1L1 transporter to dec cholesterol absorption?
Ezetimibe
Used in cholesterolemia and physosterolemia
Ezetimibe AE?
Simvastatin + fibrates - myopathy and rhabdomyolysis
Simvastatin + ezetimibe - hepatotoxicity - synergistic in lowering LDL
Cholesterol analog, takes the place of cholesterol, dec absorption?
Sitosterol
AE: GI upset. Bloating
Most effective to inc HDL, reduce TG and VLDL?
Niacin
Effect on lipid profile of: Statins Fibrates Nicotinic acid Niacin
Statins dec LDL
Fibrates dec TG
Nicotinic acid inc HDL
Niacin dec VLDL
Niacin AE?
Flushing
Pruritus
Acanthosis nigricans
GI irritation
Pre treatment with this reduces flushing in Niacin?
Aspirin or NSAIDs
Contraindication of Niacin
PUD - may worsen
“NIce! Dala ka PUDs!”
Drugs that cause flushing?
VANC
Vancomycin. Adenosine. Niacin. CCB.
Activate PPAR alpha, increase synthesis of lipoprotein lipase, dec TG?
DOC for hyperTG
Gemfibrozil (Fibrates)
Fibrates inc expression of apoproteins:
Apo A1
Apo A2
To inc HDL levels
Fibrates at risk for what stones?
Cholesterol gallstones
Drugs used for the following:
Primary hyperchylomicronemia
Dec LPL and Apo C-II
Low fat diet
Niacin + fibrates
To dec TG
Familial hypercholes
Statins - first line to dec LDL
Plus niacin and ezetimibe
PGE1 analog that is used for PUD, prevention of NSAID induced bleed but is also an abortifacient?
Misoprostol
Activate EP receptors
Inc HCO3 and mucus secretion
Misoprostol causes what sequence?
Mobius sequence (teratogenic)
PGE1 analog to maintain patency of PDA?
Alprostadil
“open - Al Fresco”
PGE2 analog for cervical ripening? But also an abortifacient
Dinoprostone
Low/high concentrations of dinoprostone relax/contract uterus?
Low contract
High relax
PGF alpha analog for post partum hemorrhage?
Carboprost
WOF bronchoconstriction
PGF 2 alpha analog for glaucoma?
Latanoprost
PGI2 analog for pulmo hypertension? Reduce platelet aggregation in dialysis machines
Epoprostenol
“EPULMO”
