Lipid-Lowering Agents--PBL 4

Question 1

Lovastatin, Provastatin, Simvastatin, Atorvastatin

Answer 1

MOA: HMG Co-A reductase inhibitor, prevents HMG-CoA -> mevalonate conversion

Adverse:hepatotoxicity, rhabdomyolysis (esp. w/ fibrates and niacin)

Question 2

Cholestyramine

Answer 2

MOA: bile acid resin. prevents uptake of intestinal bile acids. liver uses cholesterol to synthesize new bile acids de novo –> decreased cholesterol

Adverse: decreased absorption of fat-soluble vitamins

Question 3

Cholestipol

Answer 3

MOA: bile acid resin. prevents uptake of intestinal bile acids. liver uses cholesterol to synthesize new bile acids de novo –> decreased cholesterol

Adverse: decreased absorption of fat-soluble vitamins

Question 4

Colesevelam

Answer 4

MOA: bile acid resin. prevents uptake of intestinal bile acids. liver uses cholesterol to synthesize new bile acids de novo –> decreased cholesterol

Adverse: decreased absorption of fat-soluble vitamins

Question 5

Ezetimibe

Answer 5

MOA: cholesterol absorption blocker. prevents absorption of choesterol at small intestine brush border

Adverse: diarrhea

Question 6

Gemfibrozil

Answer 6

MOA: promotes activity of LPL (lipoprotein lipase), increases VLDL -> IDL conversion, less VLDL available for sub-endothelial deposition. increases triglyceride clearance

Adverse: myositis (esp. w/ statins), hepatotoxicity, cholesterol galstones (esp. w/ bile acid resins)

Question 7

Clofibrate

Answer 7

MOA: promotes activity of LPL (lipoprotein lipase), increases VLDL -> IDL conversion, less VLDL available for sub-endothelial deposition. increases triglyceride clearance

Adverse: myositis (esp. w/ statins), hepatotoxicity, cholesterol galstones (esp. w/ bile acid resins)

Question 8

Benzfibrate

Answer 8

MOA: promotes activity of LPL (lipoprotein lipase), increases VLDL -> IDL conversion, less VLDL available for sub-endothelial deposition. increases triglyceride clearance

Adverse: myositis (esp. w/ statins), hepatotoxicity, cholesterol galstones (esp. w/ bile acid resins)

Question 9

Niacin

Answer 9

MOA: vitamin B₃. decreases hepatic VLDL synthesis and inhibitis peripheral lipolysis

Adverse: red and flushed (better w/ aspirin), hyperglycemia, acanthocytosis nigricans (darking of skin folds), hyperuricemia (exacerbates gout)

Question 10

Cilostazol

Answer 10

MOA: cAMP phosphodiesterase III inhibitor, decreases platelet aggregation and increases vasodilation esp. in femoral artery beds