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Cardiac > Lipid Lowering Agents > Flashcards

Lipid Lowering Agents Flashcards

1
Q

How is hyperlipidemia described?

A

High levels of lipids in the blood

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2
Q

If a patient has hyperlipidemia what are they are at a major risk for?

A

Cardiovascular disease

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3
Q

If a patient has hyperlipidemia when do they tend to produce symptoms?

A

Typically asymptomatic until cardiovascular disease produces symptoms

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4
Q

How do genetics play a role in hyperlipidemia?

A

They determine the ability to metabolize lipids

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5
Q

How does diet and exercise effect hyperlipidemia?

A

Diets high in saturated fat and lack of exercise contribute to hyperlipidemia

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6
Q

What are the three types of lipids?

A
  • Triglycerides
  • Phospholipids
  • Steroids
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7
Q

What do lipoproteins carry?

A

Lipid molecules

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8
Q

What do lipoproteins consist of?

A
  • Cholesterol
  • Triglycerides
  • Phospholipids with protein carrier
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9
Q

What are the three types of lipoproteins?

A
  • High-density lipoprotein (HDL)
  • Low-density lipoprotein (LDL)
  • Very low-density lipoprotein (VLDL)
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10
Q

What do Low-Density Lipoproteins (LDL) enter the circulation as?

A

Tightly packed cholesterol, triglycerides, and lipids

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11
Q

What is Low-Density Lipoproteins (LDL) carried by and what are they broken down for and stored as?

A

They are carried by proteins that enter circulation.

They are broken down for energy and stored for future energy

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12
Q

How do High-Density Lipoproteins (HDL) enter the circulation as?

A

As loosely packed lipids

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13
Q

What are High-Density Lipoproteins (HDL) used for?

A

Energy

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14
Q

Where are High-Density Lipoproteins (HDL) pick up?

A

They pick up remnants of fats and cholesterol left in the periphery by LDL breakdown

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15
Q

What is the normal or desirable range for total cholesterol?

A

Less than 200

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16
Q

What is considered borderline high range for total cholesterol?

A

200-239

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17
Q

What is considered high range for total cholesterol?

A

Greater than or equal to 240

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18
Q

What is considered optimal range for low-density lipoprotein (LDL)?

A

Less than 100

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19
Q

What is considered normal or desirable range for low-density lipoprotein (LDL)?

A

100-129

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20
Q

What is considered borderline high range for low-density lipoprotein (LDL)?

A

130-159

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21
Q

What is considered high range for low-density lipoprotein (LDL)?

A

160-189

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22
Q

What is considered very high range for low-density lipoprotein (LDL)?

A

Greater than or equal to 190

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23
Q

What is considered low range for High-density lipoprotein (HDL)?

A

Less than 40

24
Q

What is considered high range for High-density lipoprotein (HDL)?

A

Greater than or equal to 60

25
Q

What is considered normal or desirable range for triglycerides?

A

Less than 150

26
Q

What is considered borderline high range for triglycerides?

A

150-199

27
Q

What is considered high range for triglycerides?

A

200-499

28
Q

What is considered very high range for triglycerides?

A

Greater than or equal to 500

29
Q

How do many patients control their dyslipidemia?

A

Through nonpharmacologic means like lifestyle changes

30
Q

What types of dietary changes can be made to keep blood-lipid levels in check?

A
  • Reduce dietary saturated fats and cholesterol

- Increase soluble fiber in diet

31
Q

What are the causes of hyperlipidemia?

A
  • Excessive dietary intakes of fats

- Genetic alterations in fat metabolism leading to a variety of elevated fats in the blood

32
Q

What are the actions of lipid lowering agents?

A
  • Lower serum levels of cholesterol and lipids

- Prevention of CAD

33
Q

What do statins interfere with?

A

The synthesis of cholesterol- they work at the cellular level

34
Q

What are the statins the drug of choice for?

A

Reducing LDL levels

35
Q

What are the CNS adverse effects of statins?

A
  • Headache
  • Dizziness
  • Blurred vision
  • Insomnia
  • Fatigue
  • Cataract development
36
Q

What is an adverse effect of statins that effect the liver?

A

Liver failure

37
Q

What is an adverse effect of statins that effect the GI tract?

A
  • Flatulence
  • Abdominal pain
  • Cramps
  • Nausea/vomiting
  • Constipation
38
Q

What is the contraindications to using statins?

A
  • Active liver disease
  • history of alcoholic liver disease
  • Pregnancy or lactation
39
Q

What do Bile Acid Sequestrants do?

A

Decrease plasma cholesterol levels

40
Q

What is the indication that bile acid sequestrants need to be used?

A

Patients with primary hypercholesterolemia- reduces elevated serum cholesterol

41
Q

What are the contraindications for using bile acid sequestrants?

A
  • Complete bile obstruction
  • Abnormal intestinal function
  • Pregnancy and lactation
42
Q

What is the prototype for bile acid sequestrants?

A

Cholestyramine

43
Q

True or False:

Cholestyramine is absorbed systemically?

A

False it is not

44
Q

What does HMG-CoA inhibitors block?

A

The enzyme HMG-CoA reductase decreasing serum cholesterol and LDL levels.

45
Q

What is the contraindications to using HMG-CoA inhibitors?

A

Active liver disease
History of alcoholic liver disease
Pregnancy or lactation

46
Q

What are the adverse effects of HMG-CoA inhibitors?

A

GI symptoms: Flatulence, abdominal pain
CNS: Headache, dizziness, blurred vision
Liver failure

47
Q

What type of juice interacts with HMG-CoA inhibitors?

A

Grapefruit juice

48
Q

What is the prototype for HMG-CoA inhibitors?

A

Atorvastatin

49
Q

What is the route, onset, peak, and duration for Atorvastatin?

A
  • Oral
  • Slow
  • 1-2 hours
  • 20 -30 hours
50
Q

What does cholesterol absorption inhibitors do?

A

-Works in the brush border of the small intestine to inhibit the absorption of cholesterol

51
Q

What should you use caution with if administering cholesterol absorption inhibitors?

A
  • Elderly patients
  • Liver disease
  • Pregnancy or lactation
52
Q

What are the adverse effects associated with cholesterol absorption inhibitors?

A
  • Abdominal pain and diarrhea
  • Headache, dizziness, fatigue
  • URI
  • Back pain
  • Muscle aches and pain
53
Q

What is the prototype for cholesterol absorption inhibitors?

A

Ezetimibe

54
Q

What is the route, onset, and peak of Ezetimibe?

A

Oral
Moderate
4-12 hours

55
Q

What three agents are used to lower lipid levels?

A
  • Niacin
  • Fenofibrates
  • Gemfibrozil

Cardiac (13 decks)

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