Lipid Flashcards
What does clinical ASCVD include? 4
- CHD
- Stroke
- TIA or
- Peripheral arterial disease
CLinical ASCVD <= 75
Secondary prevention
High-Intensity statin
Clinical ASCV > 75
Moderate intensity statin
Primary prevention groups 3
- LDL >= 190
- DM age 40-75 years with LDL b/w 70-189
- Age 40-75 with LDL b/w 70-189
DM patients age 40-75 with lLDL b/w 70-189
10 year risk >= 7.5
High intensity
DM age 40-75 LDL b/w 70-189 10 year < 7.5
Mod
Age 40-75 LDL 70-189
10 year >= 7.5
Mod intensity
High intensity statins?
Ator 40-80
Rosu: 20-40
Max dose of simvastatin with Verapamil, diltiazem and dronedarone?
10 mg/day
Max dose of simvastatin with amiodarone, amlodipine, lomitapide, ranolazine
20 mg/day
What drug should be avoided with atrovastatin?
Cyclosporin
Increased risk of myopathys with statins and what other drugs?
Gemfibrozil: fenofibrates
Niacin
When should lovastatin be taken?
At night
What has been reported with what drug and statins?
Colchine
Rhabodo
What shouldnt be used in combination?
Gemfib and Statins
Zetia
Ezitamide
Drug interaction with zetia increase?
Cyclosporin interaction bith levels can increase
What can decrease ezitamide?
Bile acid sequesterants
What to do with admin of Zetia and BASs?
Give zetia 2 hours before or 4 hours after BASs
12 drugs to avoid with simvastatin and lovastatin?
- Itraconazole
- Ketoconazole
- Posaconazole
- Voriconazole
- Erythromycin
- Clarithromycin
- HIV proteas inhibitors
- Cobistat regimens
- Nefazodone
- Cyclosporine
- Danazol with simva
- Grapefruit juice
CrCl < 60 and vytorin?
max 20 mg/day with simva
Welchol
Colesevelam
2 BASs
Cholestyramine
Colesevelam: Welchol
What BAS is also approved for glycemic control in T2DM
Welchol
COntra to welchol?
Bowel obstruction
TG>500 hc of hyper tg induec pancreatitis
How is welchol taken?
With a meal and liquid
6 SEs of BASs
Constipation, ab pain, cramping, bloating, gas, Increased TGs
What is considered an option for pregnant patietns?
Welchol
Cholestyramine and Colestipol Admin
take all other drugs 1-4 hours before or 4-6 hours after
Welchol can increase the levels of what?
Metformin
BASs can decrease aborption of what 4 things
Fat soluble vits
ADEK
Antara, TriCor, Trilipix
FEnofibrate
What do fibrates mainly do?
Decrease TG significantly
Lopid
Gemfibrozil
3 contraindications for fibrates
- Severe renal disease including primary biliary cirrhosis
- Severe renal CrCL < 30
- Gallbladder dx
2 main warnings of fibrates?
Myopathy: which is increase when given with statins
What 2 drugs should not be given with gemfibrozil?
Zetia and Statins
Gemfibrolsil is contraindicated with what other drug?
Repaglinitide
Fibrates can increase effects of what two drugs?
SUs
Warfarin
Niacin
Vit B3
Monitoring for Niacin?
Check LFTs hepatotox warning
Risk of what at what dose for niacin?
Rhabdo >=1 g/day
5 SEs of Niacin?
- FLushing
- Puritis itching
- N/V/D
- Incre BG
- Hyperuracemia or gout
What Niacin formulation has less flushing and less hepato
Niaspan
Controlled and sustained release naicin?
Has decreased flushing but increase hepatotox
IR niacin has what
Poor tolerability due to flushing
When is fish oil recommended?
Adjuct to diet when TGs>=500
What is special with Lovaza?
Increase LDL up to 44%
Fish oil interactioN?
Can increase bleeding time monitor INR if taken with warfarin
Repatha?
Evolocumab
When should you take Zocor and fluvastatin IR?
In the evening
How to take lovastatin?
with evening meal
When to take Altoprev?
at bedtime