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Pharm Unit 4 > Hypolipidemics > Flashcards

Hypolipidemics Flashcards

1
Q

Niacin (Niaspan) Class

A

Nicotinic acid

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2
Q

Gemfibrozil (Lopid) Class

A

Fibric Acid Derivatives (Fibrates)

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3
Q

Fenofibrate (Tricor) Class

A

Fibric Acid Derivatives (Fibrates)

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4
Q

Cholestyramine (Questran) Class

A

Bile acid sequestrants

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5
Q

Colestipol (Colestid) Class

A

Bile acid sequestrants

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6
Q

Colesevelam (Welchol) Class

A

Bile acid sequestrants

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7
Q

Lovastatin (Mevacor) Class

A

HMG-CoA reductase Inhibitors (statins)

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8
Q

Simvastatin (Zocor) Class

A

HMG-CoA reductase Inhibitors (statins)

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9
Q

Pravastatin (Pravachol) Class

A

HMG-CoA reductase Inhibitors (statins)

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10
Q

Fluvastatin (Lescol) Class

A

HMG-CoA reductase Inhibitors (statins)

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11
Q

Atorvastatin (Lipitor) Class

A

HMG-CoA reductase Inhibitors (statins)

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12
Q

Rosuvastatin (Crestor) Class

A

HMG-CoA reductase Inhibitors (statins)

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13
Q

Ezetimbe (Zetia) Class

A

Inhibits enterocyte absorption of cholesterol in intestine

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14
Q

Niacin (Niaspan) MOA

A

Reduction of liver triglyceride synthesis, leading to less hepatic VLDL (thus, LDL) production; decreases lipolysis in adipose tissue, leading to lowered FFA transport to liver (thus, less triglycerides); reduced hepatic clearance of ApoAI (raising HDL)

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15
Q

Gemfibrozil (Lopid) MOA

A

Unknown; may interact w/peroxisome proliferator-activated receptor (esp. PPAR_) to stimulate LPL synthesis (enhance TG-rich lipoprotein clearance); inhibit apoC III expression (enhance VLDL clearance); stimulation of apoAI and apoAII (increase HDL)

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16
Q

Fenofibrate (Tricor) MOA

A

Unknown; may interact w/peroxisome proliferator-activated receptor (esp. PPAR_) to stimulate LPL synthesis (enhance TG-rich lipoprotein clearance); inhibit apoC III expression (enhance VLDL clearance); stimulation of apoAI and apoAII (increase HDL)

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17
Q

Cholestyramine (Questran) MOA

A

Very positively charged resins binds negative charged bile acids, inhibiting reabsorption and increasing cholesterol loss; leads to increase in LDL receptors in liver (to make more cholesterol), decreasing LDL in blood

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18
Q

Colestipol (Colestid) MOA

A

Very positively charged resins binds negative charged bile acids, inhibiting reabsorption and increasing cholesterol loss; leads to increase in LDL receptors in liver (to make more cholesterol), decreasing LDL in blood

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19
Q

Colesevelam (Welchol) MOA

A

Very positively charged resins binds negative charged bile acids, inhibiting reabsorption and increasing cholesterol loss; leads to increase in LDL receptors in liver (to make more cholesterol), decreasing LDL in blood

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20
Q

Lovastatin (Mevacor) MOA

A

Inhibits HMG-CoA reductase formation of mevalonate; leads to activation of SREBP, a membrane-bound transcription factor that increases LDL-R synthesis and lessens degradation; reduction in cholesterol decreases VLDL synthesis, lowering TG

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21
Q

Simvastatin (Zocor) MOA

A

Inhibits HMG-CoA reductase formation of mevalonate; leads to activation of SREBP, a membrane-bound transcription factor that increases LDL-R synthesis and lessens degradation; reduction in cholesterol decreases VLDL synthesis, lowering TG

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22
Q

Pravastatin (Pravachol) MOA

A

Inhibits HMG-CoA reductase formation of mevalonate; leads to activation of SREBP, a membrane-bound transcription factor that increases LDL-R synthesis and lessens degradation; reduction in cholesterol decreases VLDL synthesis, lowering TG

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23
Q

Fluvastatin (Lescol) MOA

A

Inhibits HMG-CoA reductase formation of mevalonate; leads to activation of SREBP, a membrane-bound transcription factor that increases LDL-R synthesis and lessens degradation; reduction in cholesterol decreases VLDL synthesis, lowering TG

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24
Q

Atorvastatin (Lipitor) MOA

A

Inhibits HMG-CoA reductase formation of mevalonate; leads to activation of SREBP, a membrane-bound transcription factor that increases LDL-R synthesis and lessens degradation; reduction in cholesterol decreases VLDL synthesis, lowering TG

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25
Q

Rosuvastatin (Crestor) MOA

A

Inhibits HMG-CoA reductase formation of mevalonate; leads to activation of SREBP, a membrane-bound transcription factor that increases LDL-R synthesis and lessens degradation; reduction in cholesterol decreases VLDL synthesis, lowering TG

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26
Q

Ezetimbe (Zetia) MOA

A

Decreases LDL-C alone (15-20%) or in combination w/statin (60%)

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27
Q

Niacin (Niaspan) Therapy

A

Best agent to increase HDL (30-40%); as good as fibrates and statins at lowering triglycerides (35-45%); lowers LDL (20-30%); hypertriglyceridemia and low HDL

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28
Q

Gemfibrozil (Lopid) Therapy

A

Marked reduction in VLDL (thus, triglycerides); variable and small effect on LDL; small increase in HDL (10%); severe hypertriglyceridemia

29
Q

Fenofibrate (Tricor) Therapy

A

Marked reduction in VLDL (thus, triglycerides); variable and small effect on LDL; small increase in HDL (10%); severe hypertriglyceridemia

30
Q

Cholestyramine (Questran) Therapy

A

Decrease LDL (25%), but slight increase (5%) in TG and HDL

31
Q

Colestipol (Colestid) Therapy

A

Decrease LDL (25%), but slight increase (5%) in TG and HDL

32
Q

Colesevelam (Welchol) Therapy

A

Decrease LDL (25%), but slight increase (5%) in TG and HDL

33
Q

Lovastatin (Mevacor) Therapy

A

Reduce LDL (20-55%) and TG (25%), while increasing HDL (5-10%); treatment of dyslipidemia (reduces fatal & nonfatal CHD, strokes; total mortality reduction is 20%)

34
Q

Simvastatin (Zocor) Therapy

A

Reduce LDL (20-55%) and TG (25%), while increasing HDL (5-10%); treatment of dyslipidemia (reduces fatal & nonfatal CHD, strokes; total mortality reduction is 20%)

35
Q

Pravastatin (Pravachol) Therapy

A

Reduce LDL (20-55%) and TG (25%), while increasing HDL (5-10%); treatment of dyslipidemia (reduces fatal & nonfatal CHD, strokes; total mortality reduction is 20%)

36
Q

Fluvastatin (Lescol) Therapy

A

Reduce LDL (20-55%) and TG (25%), while increasing HDL (5-10%); treatment of dyslipidemia (reduces fatal & nonfatal CHD, strokes; total mortality reduction is 20%)

37
Q

Atorvastatin (Lipitor) Therapy

A

Reduce LDL (20-55%) and TG (25%), while increasing HDL (5-10%); treatment of dyslipidemia (reduces fatal & nonfatal CHD, strokes; total mortality reduction is 20%)

38
Q

Rosuvastatin (Crestor) Therapy

A

Reduce LDL (20-55%) and TG (25%), while increasing HDL (5-10%); treatment of dyslipidemia (reduces fatal & nonfatal CHD, strokes; total mortality reduction is 20%)

39
Q

Ezetimbe (Zetia) Therapy

A

Inhibits cholesterol absorption by enterocytes in jejunum (70% in mice), leading to less cholesterol in chylomicrons; reduction in chylomicron remnant cholesterol delivery to liver; may also decrease atherogenesis directly (remnants very atherogenic)

40
Q

Niacin (Niaspan) ISE

A

Flushing, pruritis of face and upper trunk, rashes, acanthosis nigricans (hyperpigmentation)

41
Q

Gemfibrozil (Lopid) ISE

A

Potentiate oral anticoagulants (displace from albumin), increase bile lithogenicity (less than clofibrate); myositis flu-like syndrome in 5%, other effects in 10% (not serious)

42
Q

Fenofibrate (Tricor) ISE

A

Potentiate oral anticoagulants (displace from albumin), increase bile lithogenicity (less than clofibrate); myositis flu-like syndrome in 5%, other effects in 10% (not serious)

43
Q

Cholestyramine (Questran) ISE

A

Very safe (only hypolipidemic indicated for children) because not systematically absorbed; impairs fat soluble vitamin absorption; binds other drugs (e.g., cardiac glycosides, coumarins)

44
Q

Colestipol (Colestid) ISE

A

Very safe (only hypolipidemic indicated for children) because not systematically absorbed; impairs fat soluble vitamin absorption, binds other drugs (e.g., cardiac glycosides, coumarins)

45
Q

Colesevelam (Welchol) ISE

A

Very safe (only hypolipidemic indicated for children) because not systematically absorbed; impairs fat soluble vitamin absorption, binds other drugs (e.g., cardiac glycosides, coumarins)

46
Q

Lovastatin (Mevacor) ISE

A

Very few; hepatic dysfunction in 1% (serious hepatotoxicity rare); myopathy/rhabdomyolysis (reduced if factors inhibiting statin catabolism lacking)

47
Q

Simvastatin (Zocor) ISE

A

Very few; hepatic dysfunction in 1% (serious hepatotoxicity rare); myopathy/rhabdomyolysis (reduced if factors inhibiting statin catabolism lacking)

48
Q

Pravastatin (Pravachol) ISE

A

Very few; hepatic dysfunction in 1% (serious hepatotoxicity rare); myopathy/rhabdomyolysis (reduced if factors inhibiting statin catabolism lacking)

49
Q

Fluvastatin (Lescol) ISE

A

Very few; hepatic dysfunction in 1% (serious hepatotoxicity rare); myopathy/rhabdomyolysis (reduced if factors inhibiting statin catabolism lacking)

50
Q

Atorvastatin (Lipitor) ISE

A

Very few; hepatic dysfunction in 1% (serious hepatotoxicity rare); myopathy/rhabdomyolysis (reduced if factors inhibiting statin catabolism lacking)

51
Q

Rosuvastatin (Crestor) ISE

A

Very few; hepatic dysfunction in 1% (serious hepatotoxicity rare); myopathy/rhabdomyolysis (reduced if factors inhibiting statin catabolism lacking)

52
Q

Ezetimbe (Zetia) ISE

A

None (rare allergies)

53
Q

Niacin (Niaspan) OSE

A

Hepatotoxicity, hyperuricemia, hyperglycemia; dyspepsia/reactivation of peptic ulcer disease; rarely, toxic ambylopia, tachyarrhythmias, a-fib (in elderly) and myopathy

54
Q

Colestipol (Colestid) OSE

A

Bloating, dyspepsia, constipation, gritty/unpleasant taste

55
Q

Colesevelam (Welchol) OSE

A

Bloating, dyspepsia, constipation, gritty/unpleasant taste

56
Q

Niacin (Niaspan) Misc

A

Water soluble B vitamin complex at [low]; hypolipidemic at [high]; side effects limit compliance (<50% eligible patients follow on it); contraindicated in DM and gout patients; prevent flushing and pruritus with ASA

57
Q

Gemfibrozil (Lopid) Misc

A

Combination w/statin inadvisable due to higher myositis risk

58
Q

Fenofibrate (Tricor) Misc

A

Combination w/statin inadvisable due to higher myositis risk

59
Q

Cholestyramine (Questran) Misc

A

Contraindicated in hypertriglyceridemia; no longer prescribed

60
Q

Colestipol (Colestid) Misc

A

Standard treatment in combo w/statin; contraindicated in hypertriglyceridemia

61
Q

Colesevelam (Welchol) Misc

A

Standard treatment in combo w/statin; contraindicated in hypertriglyceridemia

62
Q

Lovastatin (Mevacor) Misc

A

Lactone prodrug (modified in liver to hydroxy acid form); must be taken in evening; Advicor = niacin + lovastatin

63
Q

Simvastatin (Zocor) Misc

A

Lactone prodrug (modified in liver to hydroxy acid form); must be taken in evening; Vytorin = ezetemibe + simvastatin

64
Q

Pravastatin (Pravachol) Misc

A

Must be taken in evening

65
Q

Fluvastatin (Lescol) Misc

A

Must be taken in evening

66
Q

Atorvastatin (Lipitor) Misc

A

Due to longer half-life, can be taken anytime per day

67
Q

Rosuvastatin (Crestor) Misc

A

Due to longer half-life, can be taken anytime per day

68
Q

Ezetimbe (Zetia) Misc

A

Long-term decrease in endpoints not seen yet (questionable effectiveness)

Pharm Unit 4 (7 decks)

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