{ "@context": "https://schema.org", "@type": "Organization", "name": "Brainscape", "url": "https://www.brainscape.com/", "logo": "https://www.brainscape.com/pks/images/cms/public-views/shared/Brainscape-logo-c4e172b280b4616f7fda.svg", "sameAs": [ "https://www.facebook.com/Brainscape", "https://x.com/brainscape", "https://www.linkedin.com/company/brainscape", "https://www.instagram.com/brainscape/", "https://www.tiktok.com/@brainscapeu", "https://www.pinterest.com/brainscape/", "https://www.youtube.com/@BrainscapeNY" ], "contactPoint": { "@type": "ContactPoint", "telephone": "(929) 334-4005", "contactType": "customer service", "availableLanguage": ["English"] }, "founder": { "@type": "Person", "name": "Andrew Cohen" }, "description": "Brainscape’s spaced repetition system is proven to DOUBLE learning results! Find, make, and study flashcards online or in our mobile app. Serious learners only.", "address": { "@type": "PostalAddress", "streetAddress": "159 W 25th St, Ste 517", "addressLocality": "New York", "addressRegion": "NY", "postalCode": "10001", "addressCountry": "USA" } }

Lipid-lowering agents - Overview Flashcards

(18 cards)

1
Q

Which drugs have the most powerful low-density lipoprotein-lowering effects?

A

Statins have the strongest reducing effect of all of the lipid-lowering drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Other than statins, which drugs are indicated for lowering low-density lipoprotein levels?

A

Niacin, which lowers low-density lipoprotein levels, although less than statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which lipid-lowering agent causes the greatest increase in high-density lipoprotein levels? Which agents cause a more modest increase?

A

Niacin causes the greatest increase in high-density lipoprotein levels; statins have a moderate effect on high-density lipoprotein levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which lipid-lowering agents cause the most significant reduction in triglycerides? Which have a more modest benefit?

A

Fibrates reduce triglycerides most significantly; statins, bile acid resins, and niacin have a moderate effect in this regard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What adverse effects do HMG-CoA reductase inhibitors (eg, lovastatin, atorvastatin) have?

A

Elevated liver enzymes (which is reversible) and rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What adverse effects does niacin have?

A
  • Facial flushing, which can be reduced with the use of aspirin and decreases over time
  • Hyperglycemia
  • Hyperuricemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What adverse effects do bile acid resins (cholestyramine) have?

A
  • Bad taste
  • Gastrointestinal discomfort
  • Decreased effect on the absorption of fat-soluble vitamins
  • Production of cholesterol gallstones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What adverse effects do fibrates (eg, gemfibrozil, clofibrate) have?

A

Elevated liver enzymes and myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which category of lipid-lowering agents works by inhibiting the formation of the cholesterol precursor mevalonate?

A

HMG-CoA reductase inhibitors; this is the rate-limiting step in cholesterol synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which lipid-lowering agent works by inhibiting lipolysis in adipose tissue and reducing hepatic very-low-density lipoprotein secretion into circulation?

A

Niacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which category of lipid-lowering agents works by preventing the intestinal reabsorption of bile acids, causing increased hepatic usage of cholesterol to replenish the bile acids?

A

Bile acid resins (cholestyramine, colestipol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which category of lipid-lowering agents works by preventing cholesterol reabsorption at the small intestine brush border?

A

Cholesterol absorption blockers (ezetimibe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which category of lipid-lowering agents works by upregulating lipoprotein lipase, causing increased triglyceride clearance from the blood?

A

Fibrates (gemfibrozil, clofibrate, fenofibrate, bezafibrate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A 50-year-old man with hypercholesterolemia is deficient in vitamins A, D, E and K. He also complains of gastrointestinal discomfort since starting a lipid-lowering agent. Which lipid-lowering agent is the most likely cause?

A

Bile acid resins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which class of lipid-lowering agents is contraindicated in patients with gallstones?

A

Bile acid resins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A patient has recently started taking lovastatin. He presents with diffuse muscle pain and weakness. Which lab test should be ordered?

A

Creatine kinase to test for rhabdomyolysis

17
Q

Enumerate the lipid-lowering agents and their examples

A
  • HMG-CoA reductase inhibitors
    • Lovastatin
    • Pravastatin
  • Bile acid resins
    • Cholestyramine
    • Colestipol
    • Colesevelam
  • Cholesterol absorption inhibitor
    • Ezetimibe
  • Fibrates
    • Gemfibrozil
    • Bezafibrate
    • Fenofibrate
  • Niacin (vitamin B3)
  • PCSK9 inhibitors
    • Alirocumab
    • Evolocumab
18
Q

Which class cause inactivation of LDL-receptor degradation, increasing amount of LDL removed from bloodstream

A

PCSK9 inhibitors (i.e., Alirocumab, evolocumab)