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2 - CPR (cardio) > LDL Lowering Medications > Flashcards

LDL Lowering Medications Flashcards

1
Q

What 4 statins lower LDL in low-medium decrease range?

A

Lovastatin
Fluvastatin
Pravastatin
Simvastatin

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2
Q

What 4 statins lower LDL in low-medium decrease range?

A

Lovastatin
Fluvastatin
Pravastatin
Simvastatin

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3
Q

What 2 statins lower LDL in medium-high decrease range?

A

Atorvastatin

Rosuvastatin

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4
Q

What 2 statins lower LDL in medium-high decrease range?

A

Atorvastatin

Rosuvastatin

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5
Q

MOA for statins?

A

(-) HMG-CoA Reductase

– enzyme needed to form cholesterol

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6
Q

Why are the systemic concentrations of statins very low?

A

Liver extracts it from blood, metabolizes it and then excretes in bile

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7
Q

Contraindications for taking Statins?

A

Pregnancy
Liver disease
Other drugs that affect CYP450
Gemfibrozil

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8
Q

What drug should be not be taken with Statins?

A

Gemfibrozil (fibrate)

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9
Q

What are the possible side effects of statins?

A

New onset diabetes

Myalgias

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10
Q

Which statin drugs have a higher risk of causing new onset diabetes?

A

Atorvastatin

Rosuvastatin

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11
Q

If statins are not working as well as they should be, what is the next drug of choice to add?

A

Ezetimibe (NPC1L1 (-))

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12
Q

MOA for Ezetimibe

A

(-) NPC1L1 to block absorption of cholesterol in gut and liver

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13
Q

MOA for Ezetimibe

A

(-) NPC1L1 to block absorption of cholesterol in gut and liver

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14
Q

Ezetimibe blocks absorption of cholesterol, which will then increase what receptors on the cells?

A

LDL – decreases LDL in blood stream

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15
Q

What genetic disorder is Ezetimibe approved for?

A

Homozygous Sitosterolemia

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16
Q

Contraindication for Ezetimibe?

A

Liver disease

17
Q

Common side effects of Ezetimibe?

A

Headache, runny nose and sore throat

18
Q

If Ezetimibe does not work well with statins, what can be added instead?

A

PCSK9 (-)s

19
Q

What are the PCSK9 (-)’s?

A

Evolocumab

Alirocumab

20
Q

What are the PCSK9 (-)’s?

A

Evolocumab

Alirocumab

21
Q

How are Evolocumab and Alirocumab given and which as more site reactions?

A

SubQ injections

- Alirocumab has more injection site rxns

22
Q

Overall result of PCSK9 (-)’s?

A

Increase LDL receptors on hepatocytes

23
Q

What are the Bile Acid Sequestrants?

A

Cholestyramine
Colestipol
Colesevelam

24
Q

What are the Bile Acid Sequestrants?

A

Cholestyramine
Colestipol
Colesevelam

25
Q

Of the Bile acid sequestrants, which is newer and is tolerated better with less side effects?

A

Colesevelam

26
Q

What does Colesevelam contain that some patients with Phenylketonuria should watch out for?

A

Phenylalanine

27
Q

Describe how Bile Acid Sequestrants work?

A
  • Binds to bile acids to make them insoluble
  • Excreted in feces
  • This causes an increase in synthesis of bile acids from cholesterol
    = Decreases LDL cholesterol
28
Q

Describe how Bile Acid Sequestrants work?

A
  • Binds to bile acids to make them insoluble
  • Excreted in feces
  • This causes an increase in synthesis of bile acids from cholesterol
    = Decrease in LDL cholesterol
29
Q

What else can Bile Acid Sequestrants treat?

A

Pruritus from cholestatic liver disease

30
Q

What are the contraindications for Bile Acid Sequestrants?

A
  • Serum TG > 400 –> can cause pancreatitis

- Dysbetalipoproteinemia

31
Q

What are the possible side effects of Bile Acid Sequestrants?

A
  • Constipation, hemorrhoids, flatulence
  • Nausea, dyspepsia, abdominal pain
  • Decrease in fat soluble vitamins (ADEK)
  • Elevated liver enzymes
32
Q

What are the possible side effects of Bile Acid Sequestrants?

A
  • Constipation, hemorrhoids, flatulence
  • Nausea, dyspepsia, abdominal pain
  • Decrease in fat soluble vitamins (ADEK)
  • Elevated liver enzymes
33
Q

What vitamin can decrease TG’s, LDL and increase HDL?

A

Niacin (B3)

34
Q

What vitamin can decrease TG’s, LDL and increase HDL?

A

Niacin (B3)

35
Q

Why is Vitamin B3 no longer recommended?

A

No decrease in mortality

36
Q

What are the possible side effects of Vitamin B3?

A

Flushing, pruritus, GI distress

New onset diabetes, angina, hyperuricemia

37
Q

What are the possible side effects of Vitamin B3?

A

Flushing, pruritus, GI distress

New onset diabetes, angina hyperuricemia

2 - CPR (cardio) (44 decks)

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