Lipids Flashcards
What makes up Hyperlipidemia?
increased LDL
decreased HDL
increased triglycerides
Goal for total cholesteral
less than 200
goal for triglycerides
less than 150
goal for HDL
greater than 60
LDL goal in a person with DM + CAD
less than 70
LDL goal in a person with CAD + HTN
less than 100
Optimal LDL for regular people
less than 100
LDL 100-129
normal
LDL 130-159
borderline
LDL 160-189
high
LDL 190+
very high
LDL a person with HTN
less than 100
A patient with triglycerides greater than 500 are at risk for what?
pancreatitis
main cause of hyperlipidemia
genetics
What are the secondary causes of hyperlipidemia?
hypothyroidism diabetes biliary cirrhosis smoking obesity chronic renal disease Protease inhibitors (tx for aids) Thiazide diuretics
A guy has hypertension which is under control with medication. Now he comes in and has LDL of 160. What do you do?
take him off the thiazide diuretic you placed him on for HTn
An aids patient now has an LDL of 160. What is the first medication you think of that might be causing his hyperlipidemia?
-Protease inhibitors for his AIDS tx
The presence of all five of these constitute Metabolic Syndrome which increase the risk of a cardiac event.
- abd obesity
- increased triglycerides
- decreased HDL
- HTN
- Hyperglycemia
When do you start someone on a statin?
+ASCVD (advanced sclerotic coronary vasc. disease)
LDL greater than or equal to 190
Diabetes
10 year risk greater than or equal to 7.5%
What is the effect of statin on LDL, LDL and triglycerides?
- good lowering of LDL
- min effect on HLD
- mild lowering of triglycerides
Can a statin cause rhabdomyolysis?
yes, and especially when combined with a fibrate (fenofibrate or Gemfibrozil)
Side effects of statins/
myopathy rhabdomyolisis hepatotoxicity renal failure pancreatitis
Who should not be given statins?
hepatic/liver disease
increased LFT (liver function test)
pregnacy
myopathy
Niacin has it’s best effects on which lipids?
- decreases triglycerides
- increases HDL’s
- little effect LDL
Would you give niacin to a diabetic?
no, it increases blood sugar levels
Contraindications for niacin?
hepatic disease
increase liver function test (LFT)
peptic ulcer
Fibrates do what to lipid?
lower triglycerides
limited lowering of LDL
Side effects of Fibrates?
hepatitis, cirrhosis, cholelethiasis
myopathy
rhabdomyolysis
abdominal pain
Don’t give fibrates to these people?
hepatic impairment severe renal impairment increase liver function tests biliary cirrhosis gall bladder disease
Why would you prescribe Lovaza (omega-3 FA) ?
to lower triglycerides
What are the side effects of Lovasa omega-3 ?
dsypepsia
nausea
fish taste
You have a patient with high triglycerides, what would stop you from prescribing Lovasa omega-3?
a fish allergy
Ezetimibe is used to lower affect lipids?
triglycerides
LDL
Which lipid medication causes Angioedema?
-Ezetimibe
Which 2 lipid medications cause pancreatitis?
-Ezetimbe and statins
Which lipid meds cause hepatitis?
fibrates and Ezetimibe
When prescribing statins what lab do you order when they return for follow up?
-liver function tests
Which lipid med causes constipation?
-Bile sequestration meds
cholestryrmine
colsevelam
Which lipid med causes Metabolic Acidosis?
- cholestyramine
- colesevelam
