Nicole - Anti-Lipid Agents

Question 1

What are the Categories for Anti-hyperlipidemia medications?

Answer 1

1. HMG-CoA reductase inhibitors
2. Bile acid sequestrants
3. fabric acids
4. nicotinic acid
5. cholesterol absorption inhibitor
6. other (Omega 3 fatty acid)
7. PCSK9 Inhibitor

Question 2

What are the high intensity statins?

They reduce LDL by >50%

Answer 2

• Atorvastatin (lipitor) 40-80mg

- Rousuvastatin (crestor) 20-40mg

Question 3

What are the moderate intensity statins?

reduce LDL by 30-49%

Answer 3

Atorvastatin 10-20mg
Rosuvastatin 5-10mg
Simvastatin 20-40mg
Provastatin 40-80mg
Lovastatin 40mg
Fluvastatin 40mg BID

Question 4

What is the MOA of Atorvastatin

Answer 4

inhibits cholesterol synthesis

Question 5

What is the best combo LDL/Triglyceride reduction of the statins?

Answer 5

Atorvastatin

Question 6

What are some important things to remember about Lovastatin

Answer 6

Use cautiously in decreased renal function

Question 7

What are some important things to remember about Pravastatin

Answer 7

Not CYP450 metabolized

Caution in renal, hepatic dysfunction

Question 8

What are some important things to remember about Rosuvastatin?

Answer 8

Second most potent for combo LDL/Triglyceride reduction

Caution renal or hepatic dysfunction

Question 9

What are some important things to remember about Simvastatin

Answer 9

No longer use the 80mg dose

caution in renal dysfunction

Question 10

What are some important things to remember about Fluvastatin

Answer 10

Daily or twice daily dosing

Question 11

What is the class of Cholestyramine

Answer 11

Bile acid sequestrant

Question 12

What are the indications for cholestyramine?

Answer 12

Hypercholesterolemia

Question 13

Cholestyramine is moderately effective lowering cholesterol but doesn’t lower what?

Answer 13

triglycerides

Question 14

What is the class of colesevelam?

Answer 14

Bile acid sequestrant

Question 15

What are the indications of Colesvelam

Answer 15

LDL reduction
DM2
Usually adjust therapy

Question 16

Describe the MOA of Colesevelam

Answer 16

Binds bile acids inhibiting enterohepatic circulation of cholesterol

Question 17

What is the class of Gemfibrozil?

Answer 17

Fibrate

Question 18

What are the indications of gemfibrozil

Answer 18

hypertriglyceridemia

Low LDL

Question 19

What drugs to you need to avoid with the use of gemfibrozil?

Answer 19

Clopidogrel
Repaglinide
Warfarin

Question 20

Fenofibrate is in what drug class?

Answer 20

Fibrate

Question 21

The Indications for fenofibrate are what?

Answer 21

Hypertriglyceridemia

Low HDL

Question 22

What are the most effective triglyceride lowering agents?

Answer 22

Gemfibrozil

Fenofibrate

Question 23

The vitamin B3 mediation is what?

Answer 23

Nicotinic acid

Question 24

The indications of Nicotinic acid includes what?

Answer 24

Hypertriglyceridemia
low HDL
high LDL

Question 25

The MOA of nicotinic acid is what?

Answer 25

inhibits fatty acid release from adipose tissue and hepatic triglyceride production

Question 26

Exetimibe is in what drug class?

Answer 26

Cholesterol absorption inhibitor

Question 27

Why do you use exetimibe?

Answer 27

For Hypercholesterolemia

Question 28

The MOA of Exetimibe is what?

Answer 28

Decreases absorption of cholesterol from GI tract

Question 29

What are the indications for Omega 3 fatty acids?

Answer 29

High trig despite diet, alcohol restriction and fibrates

Question 30

Evolocumab is in what drug class?

Answer 30

monoclonal antibody PCSK9 inhibitor

Question 31

The indication of Evolocumab include what?

Answer 31

drug resistant hyperlipidemia

especially homozygous familial hypercholesterolemia

Question 32

MOA of evolocumab

Answer 32

human monoclonal antibody that binds to proprotein convertase subtilisin kexin type 9 (PCSK9) inhibiting the degradation of LDLR; this increases the number of LDLRs available to clear LDL from the blood thereby lowering LDL-C levels