Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Lipid Lowering Drugs (Antilipemic drugs) - Ch. 53 > Flashcards

Lipid Lowering Drugs (Antilipemic drugs) - Ch. 53 Flashcards

1
Q

What are the 2 primary forms of lipids in blood?

A

Tryglycerides (TGs)
Cholesterol

-Water-insoluble fats
-Must be packaged for transport in blood

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

What are Lipoproteins?

A

Combination of lipids with proteins

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

What are some examples of Lipoproteins?

A

Chylomicrons
Very-low density lipoprotein (VLDL)
Low-density lipoprotein (LDL)
High-density lipoprotein (HDL)

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

Where are chylomicrons produced?

A

GI tract

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

Where are Very-low density lipoprotein (VLDL) produced?

A

Liver

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

What do Very-low density lipoprotein (VLDL) do?

A

Transport triglycerides to cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is LDL?

A

“Less desired”, “bad cholesterol”
-Cholesterol rich

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is LDL used for?

A

-Binds to receptors on cell membranes
-Cholesterol source during production of steroid hormones

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

What is HDL?

A

“highly desired” “good cholesterol”
-prevents cholesterol from building up in vessels

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

What does HDL do?

A

Absorbs cholesterol and transports it to the liver where it is recycled

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

What are some non-modifiable factors leading to coronary artery disease?

A

Age
-Male 45 years or older
-Female 55 years or older, or postmenopausal

Family history
-strong history of premature Congenital heart disease

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

What are some modifiable factors leading to coronary artery disease?

A

Current cigarette smoker
Abdominal obesity
Hypertension (BP- 140/90 or higher, or on antihypertensive drugs)
Diabetes mellitus
LDL/HDL ration

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

What are the 4 groups of lipid lowering drugs?

A
  1. HMG-CoA reductase inhibitors (HMGs, or statins)
  2. Inhibitors of Cholesterol Absorption
  3. Niacin (nicotinic acid)
  4. Fibric acid derivatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is HMG-CoA?

A

3-Hydroxy-3-methylglutaryl coenzyme A

One of age metabolites in the cholesterol synthesis pathway

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

What is HMG-CoA reductase?

A

Critical enzyme for liver cholesterol production

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

What do HMG-CoA reductase inhibitors do?

A

Reduce plasma LDL levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of HMG-CoA reductase inhibitors?

A

Atorvastatin (lipitor)
Rosuvastatin (Crestor) -possibly less AE
Lovastatin (Mevacor)
Simvastatin (Zocor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the mechanism of action of HMG-CoA reductase inhibitors?

A

Inhibit HMG-CoA reductase
Lower rate of cholesterol production

19
Q

Because HMG-CoA reductase inhibitors lower the rate of cholesterol production what happens?

A

Increased liver LDL receptors which increases plasma clearance of LDL

20
Q

What are the added benefits of Statins/HMG-CoA reductase inhibitors?

A

Decrease VLDL (major carriers of TGs)
Raise HDL
-improves LDL/HDL ratio

21
Q

What are HMG-CoA reductase inhibitors used for?

A

First-line drug therapy for hypercholesterolemia
Treatment of types of II and IIb hyperlipidemias
-high LDL levels

22
Q

What adverse effects are associated with HMG-CoA reductase inhibitors?

A

Mild, transient GI disturbances
headache
Muscle pain (myalgia)
Rhabdomyolysis (rarer)
Liver injury (increased liver enzymes)

23
Q

When is HMG-CoA reductase inhibitors use contraindicated?

A

Preganancy
Use with caution with liver dysfunction patients e.g, viral hepatitis

24
Q

What racial group should have a lower dose of rosuvastatin?

A

Asians

25
Q

What can some HMG-CoA reductase inhibitors interact with that isn’t a drug?

A

Grapefruit juice
-Causes CYP3A4 inhibition

26
Q

What HMG-CoA reductase inhibitors interact with grapefruit juice?

A

Lovastatin
simvastatin
atorvastatin

27
Q

What drugs do HMG-CoA reductase inhibitors interact with?

A

Drug inhibitors of CYP3A4
-warfarin (oral anticoagulant)
-erythromycin (macrolide antibacterial)
-ritonavir (HIV protease inhibitor)

28
Q

What are some drugs that inhibit cholesterol absorption/

A

Bile acid-binding resins
Ezetimibe

29
Q

Examples of Bile acid-binding resins (bile acid sequestrants)?

A

Cholestyraminde
Colestipol

30
Q

What is the mechanism of action of bile acid sequestrants?

A

Prevent reabsorption of bile acids from small intestine
-bile acids are synthesised from cholesterol in the liver
-liver stimulated to produce more bile acids

31
Q

What are bile acid sequestrants used for?

A

Type II hyperlipoproteinemia
relief of Pruritus associated with partial biliary obstruction (cholestyramine)

32
Q

What adverse effects are associated with bile acid sequestrants?

A

GI disturbances : constipation, heartburn, nausea, belching, bloating
(tend to disappear over time)

Decrease absorption of fat soluble vitamins A, D, E,K

33
Q

What are fibric acid derivatives (fibrates) mechanism of action?

A

complex
-Believed to work by activating lipoprotein lipase (which breaks down TGs in lipoproteins)
-Reduces plasma TGs
-Increase fatty acid use in tissues

34
Q

What do fibric acid derivatives (fibrates) do?

A

Decrease plasma triglyceride levels
Increase HDL bias much as 10-25%

35
Q

Examples of fibric acid derivatives (fibrates)?

A

gemfibrozil
bezafibrate (Bezalip)
fenofibrate (Lipidil)

36
Q

What adverse effects are associated with fibric acid derivatives (fibrates)?

A

GI disturbances : abdominal discomfort, diarrhoea, nausea
Blurred vision
Increased risk of gallstones
Prolonged prothrombin time (fibrinogen production reduces, displacement of anticoagulants from albumin)

37
Q

What is Nicotinic Acid (Niacin)?

A

Vitamin B3

38
Q

What does Nicotinic acid (Niacin) do?

A

Reduce plasma TGs

39
Q

What is required dosing wise when Niacin is given for its lipid lowering properties rather than just as a vitamin?

A

Needs a much higher dose (grams)

40
Q

Why is Niacin used?

A

Effective and inexpensive
-often in combination with the lipid-lowering agents e.g, statins

41
Q

What is the mechanisms of action of niacin?

A

Reduces VLDL (TGs carrier) from liver
-Inhibits lipase in adipose tissue (breaks down lipids)
-less fatty acids for TG production in liver

42
Q

What adverse effects are associated with Niacin/ Nicotinic acid?

A

Flushing (PG release)
Pruritis (anal itchiness)
GI distress

43
Q

How is flushing caused by nicotinicn acid (niacin) prevented?

A

take Aspirin 30 minutes before

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions