Lipid management in PWD

Question 1

Age < 40 No ASCVD; no 10 year risk > 20%

Answer 1

No statins

Question 2

Age < 40 with ASCVD risk > 20%

Answer 2

High dose statin/combo

Question 3

Age 40 or more, no CVD but with > 20% risk ASCVD

Answer 3

moderate intensity statins

Question 4

age 40+ with ASCVD and > 20% risk

Answer 4

high intensity; if LDL > 70 add ezetimibe or PCSKA inhibitor

Question 5

ASCVD risks include:

Answer 5

LDL > 100, HTN, CKD, Albuminuria, Fam hx ASCVD

Question 6

Age 20-39

Answer 6

If Type 2 > 10 years or Type 1 > 20 years, > 30 mg albuminurea-> Moderate intensity statins

Question 7

Age 40-75 regardless of ASCVD risk

Answer 7

moderate intensity statins with goal decrease LDL by 30%

Question 8

Age 75 or older

Answer 8

ASCVD risk not valid; continue present tx; if none- consider pros/cons

Question 9

All agese with clinical ASCVD or 10 year risk > 20%

Answer 9

High intensity rx with goal LDL-C reduction 50%

Question 10

TG modesly elevated (175-499)

Answer 10

Initiate or intensify statins add icospent ethyl2 g BID or fenofibrate

Question 11

Severe TG elevations > 500 mg/dL

Answer 11

goal is prevent pancreatitis; initiate/intensify statins; add fibrate or omega 3 FA

Question 12

Diet recs for elevated TG

Answer 12

Weight loss; limit carbs, avoid etoh; very low fat diet

Question 13

Atorvistatin

Answer 13

Lipitor; 10-80 mg daily

Question 14

Lipitor AE

Answer 14

myopathy: ** Don’t use if LFTs 3X UL normal

Question 15

Each doubling of lipitor dose reduces LDL _____%

Answer 15

7

Question 16

Rosuvastatin (crestor) dosing

Answer 16

5-40 mg daily

Question 17

Rosuvastatin AE

Answer 17

myopthy

Question 18

Simvastatin (Zocor) dosing

Answer 18

5-40 mg daily

Question 19

Which drugs can cause myopathy

Answer 19

statins

Question 20

Statins can reduce LDL by _____% and TG by ____

Answer 20

18-55 and 7-30

Question 21

Colesevelam (welChol) MOA

Answer 21

Bile acid sequestrant DONT use if TG > 300

Question 22

cholestyramine MOA

Answer 22

Bile acid sequestrant

Question 23

Colestipol precautions with other meds

Answer 23

bile acid seqestrant; interacts with many other drugs. Take one hour before or 4 hours after other meds

Question 24

Fibrate meds examples:

Answer 24

Gemfibrizol (Lopid) Fenofibrate (Tricor)

Question 25

Fibrate caution

Answer 25

kidney liver dysfunction

Question 26

Which fibrate should not be used with simvastatin

Answer 26

Gemfibrozil ((Lopid); better to use Fenofibrate (Tricor) for less myopathy

Question 27

Ezetimibe MOA

Answer 27

absorption inhibitor

Question 28

Vytor combines simvastatin with _______

Answer 28

Ezetemibe