Lipid Lowering Drugs

Question 1

Cholestyramine pharm class

Answer 1

bile acid sequestrant

Question 2

Cholestyramine therapeutic class

Answer 2

lipid lowering

Question 3

Cholestyramine pharmdynamics

Answer 3

• forms non-absorbable complex w/ bile acids in small bowel and inhibits enterohepatic reuptakeof intestinal bile salts
• increseases expression of LDL receptor
• reduces cholesterol by 10-20%

Question 4

Cholestyramine absorbtion

Answer 4

virtually none

Question 5

Cholestyramine peak

Answer 5

3 weeks

Question 6

Cholestyramine 3 toxicity issues

Answer 6

Gi issues
decreased vitamin absorption
interferes w/ statin, steroid, dig, warfarin, and thyroxine absorption

Question 7

Cholestyramine route

Answer 7

powder/ oral

Question 8

Niacin pharm class

Answer 8

vitamin

Question 9

Niacin therapeutic class

Answer 9

lipid lowering

Question 10

Niacin pharmacodynamics

Answer 10

lowers TG and LDL
decreases production of bad lipoproteins
can increases LDL receptor

Question 11

Niacin absorption (qualitative)

Answer 11

good

Question 12

niacin relationship w/ liver

Answer 12

large 1st pass effect to nicotinamide

Question 13

niacin tmax

Answer 13

45 minutes

Question 14

how is niacin excreted

Answer 14

urinary excretion of drug and metabolite

Question 15

niacin toxicity (2)

Answer 15

skin flushing

hepatitis

Question 16

avoid niacin in

Answer 16

CAD and heavy ETOH use

Question 17

Gemfibrozil pharm class

Answer 17

fibric acid derivative

Question 18

what is Gemfibrozil most usefulf or?

Answer 18

treating hypertriglyceridemia in type IV and V hypertriglyceridemia

Question 19

how is Gemfibrozil absorbed (qualitiatively)

Answer 19

well

Question 20

where is Gemfibrozil metabolized

Answer 20

liver

Question 21

Gemfibrozil half life

Answer 21

1-2 hours

Question 22

Gemfibrozil interactions

Answer 22

increases liver and muscle toxicity when combined with statins

Question 23

Gemfibrozil contraindications

Answer 23

liver and renal disease

Question 24

Atorvastatin cost

Answer 24

$10

Question 25

Atorvastatin pharm class

Answer 25

HMG-coA reductase inhibitor

Question 26

Atorvastatin therapeutic class

Answer 26

lipid lowering and prevention of CAD

Question 27

Atorvastatin pharm dynamics

Answer 27

• inhibits HMG-COA reductase which is regulatory step in cholesterol synthesis
• increases LDL receptors
• leads to 10-65% reduction in cholesterol and small increaes in HDL

Question 28

Atorvastatin metabolized where

Answer 28

liver

Question 29

Atorvastatin metabolized by what enzyme

Answer 29

CYP3A4

Question 30

what is more active Atorvastatin or metabolites

Answer 30

metabolites

Question 31

Atorvastatin half life

Answer 31

20-30 hours

Question 32

What do you have to monitor for Atorvastatin

Answer 32

LFT and CPK ie liver and kidneys

Question 33

effects of Atorvastatin toxicity

Answer 33

hepatitis, myopathy, myositis, rhabdomyolysis

Question 34

avoid Atorvastatin in which situation

Answer 34

hepatitis, muscle disease, and pregnancy class (x)

Question 35

How does Ezetimibe work ie pharmacodynamics?

Answer 35

blocks intestinal uptake of choelsterol which leads to increased blood clearance of cholesterol

Question 36

how is Ezetimibe absorbed (qualitatively()

Answer 36

bad

Question 37

how is Ezetimibe used

Answer 37

only in addition to statins

Question 38

what is Ezetimibe’s effect on outcomes

Answer 38

doesn’t reduce MI, stroke, or CV outcomes