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kekw > PCOL MIDTERM 2 > Flashcards

PCOL MIDTERM 2 Flashcards

Para manlang maka tres

1
Q

Soft waxy substance

A

Cholesterol

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2
Q

Cholesterol is found among

A

Lipids (FATS) in the bloodstream and all cells

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3
Q

Transport vehicles

A

Lipoproteins

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4
Q

Lipoproteins delivers

A

Cholesterol, Triglycerides, and Phospholipids in the Bloodstream

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5
Q

Cholesterol are delivered to various body tissues to be

A

Used, Stored or Excreted

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6
Q

Excess circulating cholesterol leads to

A

Plaque formation

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7
Q

LDL stands for

A

Low-Density Lipoprotein

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8
Q

LDL is also known as

A

BAD cholesterol

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9
Q

The major cholesterol carrier in the blood

A

Low-Density Lipoprotein

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10
Q

HDL stands for

A

High-Density Lipoprotein

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11
Q

HDL is also known as

A

GOOD cholesterol

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12
Q

Transport cholesterol away from arteries and back to the liver to be excreted

A

High-Density Lipoprotein

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13
Q

Removes excess cholesterol from plaques and slowing the growth

A

High-Density Lipoprotein

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14
Q

VLDL stands for

A

Very-Low-Density Lipoprotein

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15
Q

Secreted by the liver

A

VLDL

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16
Q

It export Triglycerides and Cholesterol to peripheral tissues

A

VLDL

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17
Q

Peripheral tissues are

A

Precursor of LDL

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18
Q

Chemical form in which most fat exists

A

Triglycerides

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19
Q

Triglycerides fats came from

A

Food as well as in the body

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20
Q

Triglycerides develop when calories are

A

NOT burned RIGHT AWAY and are stored in fat cells

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21
Q

Store unused calories and provide your body with energy

A

Triglycerides

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22
Q

Formed in the intestine and carry triglycerides from dietary origin

A

Chylomicrons

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23
Q

AKA Hyperlipoprotein

A

Hyperlipidemia

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24
Q

AKA Dyslipidemia

A

Hyperlipidemia

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25
Q

Hyperlipoproteinemia is also known as

A

Hyperlipoprotein and Dyslipidemia

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26
Q

Hyperlipidemia is also known as

A

Hyperlipoproteinemia and Dyslipidemia

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27
Q

It describe an increased concentration of the lipoprotein macromolecule that transport lipids in the plasma

A

Hyperlipidemia

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28
Q

lipoprotein macromolecule transport lipids in the

A

Plasma

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29
Q

Also called High Cholesterol

A

Hypercholesterolemia

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30
Q

Medical term for abnormally high levels of cholesterol in the blood

A

Hypercholesterolemia

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31
Q

Elevated Total Cholesterol (TC)

A

Hypercholesterolemia

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32
Q

A condition in which triglyceride levels are elevated

A

Hypertriglyceridemia

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33
Q

Elevated Triglycerides (TG)

A

Hypertriglyceridemia

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34
Q

A disorder in which the body does not break down fats (lipids) correctly

A

Chylomicronemia

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35
Q

Deficiency of Chylomicrons

A

Chylomicronemia

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36
Q

A rare lipoprotein metabolism disorder

A

Hypoalphalipoproteinemia

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37
Q

Deficiency of HDL

A

Hypoalphalipoproteinemia

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38
Q

Ideal Fasting Blood Level for Total Cholesterol

A

< 200 mg/dl

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39
Q

Ideal Fasting Blood Level for LDL-Cholesterol

A

< 100 mg/dl

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40
Q

Ideal Fasting Blood Level for HDL-Cholesterol

A

> or = 60 mg/dl

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41
Q

Ideal Fasting Blood Level for Triglycerides

A

< 150 mg/dl

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42
Q

Single or Multiple Gene Mutation

A

Primary Dyslipidemia

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43
Q

Results in Disturbance of LDL, HDL, and Triglycerides production or clearance

A

Single or Multiple Gene Mutation

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44
Q

Presence of Risk Factors, Should be suspected in patients with:

A
  • Premature Heart Disease
  • Family hx of atherosclerotic
  • Serum cholesterol level > 240 mg/dl
  • Physical signs of hyperlipidemia
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45
Q

Genetic Factors cause primary dyslipidemia, and its genetic inherited.

A
  • Familial combined hyperlipidemia
  • Familial Hyperapobetalipoproteinemia
  • Familial hypertriglyceridemia
  • Homozygous familial or polygenic hypercholesterolemia
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46
Q

A genetic factor that causes a mutation in LDL receptors

A

Homozygous familial or polygenic hypercholesterolemia

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47
Q

A genetic factor which leads to high triglycerides levels

A

Familial hypertriglyceridemia

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48
Q

A genetic factor that causes a mutation in a group of LDL lipoproteins

A

Familial Hyperapobetalipoproteinemia

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49
Q

A genetic factor which develops in teenagers and young adults and can lead to high cholesterol

A

Familial combined hyperlipidemia

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50
Q

A mutation in a group of LDL lipoproteins called

A

apolipoproteins

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51
Q

Secondary Dyslipidemia Causes (First 5)

A
  • Obesity
  • Sedentary lifestyle
  • Excessive consumption of Cholesterol (Saturated fats and
    Trans-Fatty acid)
  • Diabetes (Type 2 DM)
  • Hypothyroidism
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52
Q

Secondary Dyslipidemia Causes (6-10)

A
  • Cholestatic liver disease
  • Nephrotic syndrome
  • Cigarette smoking
  • Alcoholism
  • Cushing’s syndrome
53
Q

Drugs causing MILD to MODERATE degrees of Dyslipidemia

A
  • Beta-Blockers
  • Thiazide diuretics
  • Antiretroviral drugs
  • Hormonal Agents
54
Q

Drug that causes MILD to MODERATE degrees of dyslipidemia due to inhibition of lipolysis (Beta 3)

A

Beta-blockers

55
Q

Drug that causes MILD to MODERATE degrees of dyslipidemia due to 5-15% increase in total serum cholesterol and LDL

A

Thiazide diuretics

56
Q

What are the Lipoprotein Class

A
  • HDL
  • LDL
  • IDL
  • VLDL
  • Chylomicrons
57
Q

HDL Density

A

1.063-1.21

58
Q

HDL Diameter

A

5-15

59
Q

LDL Density

A

1.019-1.063

60
Q

LDL Diameter

A

18-28

61
Q

IDL Density

A

1.006-10.19

62
Q

IDL Diameter

A

25-50

63
Q

VLDL Density

A

0.95-1.006

64
Q

VLDL Diameter

A

30-80

65
Q

Chylomicrons Density

A

<0.95

66
Q

Chylomicrons Diameter

A

100-500

67
Q

Severe or untreated dyslipidemia can lead to other conditions, including

A

Coronary Artery Disease (CAD) and Peripheral Artery Disease (PAD).

68
Q

Both CAD and PAD can cause serious health complications, including

A

Heart attacks and Strokes

69
Q

One of the major sequelae of Hyperlipidemia

A

Atherosclerosis

70
Q

Process of forming atheromas, plaques in the inner lining (the intima) of arteries is

A

Atherogenesis

71
Q

A condition correlated with high plasma lipid levels of cholesterol - and/or containing lipoprotein particles.

A

Coronary Artery Disease (CAD)

72
Q

Symptoms associated with CAD and Atherosclerosis

A
  • Leg pain, especially when walking or standing
  • Chest pain
  • Tightness or pressure in the chest and shortness of breath
  • Pain, tightness, and pressure in the neck, jaw, shoulders, and back
  • Indigestion and Heartburn
  • Sleep problems and Daytime exhaustion
  • Dizziness
  • Heart palpitations
  • Cold sweats
  • Vomiting and Nausea
  • Swelling in the legs, ankles, feet, stomach, and veins of the neck
72
Q

Symptoms associated with CAD and Atherosclerosis

A
  • Leg pain, especially when walking or standing
  • Chest pain
  • Tightness or pressure in the chest and shortness of breath
  • Pain, tightness, and pressure in the neck, jaw, shoulders, and back
  • Indigestion and Heartburn
  • Sleep problems and Daytime exhaustion
  • Dizziness
  • Heart palpitations
  • Cold sweats
  • Vomiting and Nausea
  • Swelling in the legs, ankles, feet, stomach, and veins of the neck
73
Q

Non-pharmacologic Intervention for CAD and Atherosclerosis

A
  • Weight reduction (especially in overweight px)
  • Increase physical activity
  • Smoking cessation and avoid alcohol consumption
  • Diet modifications (reduce consumption of unhealthy fats, such as those found in red meats, full-fat dairy products, refined carbohydrates, chocolate, chips, and fried foods)
  • Eat plenty of Dietary Fibers (Fruits, Vegetables, Whole Grains) and drink plenty of water
  • Take OMEGA-3
74
Q

Recommended intake for Total Fat

A

25-35% of total calories

75
Q

Recommended intake for Saturated Fat

A

<7% of total calories

76
Q

Recommended intake for Polyunsaturated Fat

A

Up to 10% of total calories

77
Q

Recommended intake for Monosaturated Fat

A

Up to 20% of total calories

78
Q

Recommended intake for Carbohydrates

A

50-60% of total calories

79
Q

Recommended intake for Fiber

A

20-30 g/day

80
Q

Recommended intake for Cholesterol

A

<200 mg/day

81
Q

Recommended intake for Protein

A

15% of total calories

82
Q

Pharmacologic Intervention for CAD and Atherosclerosis

A
  1. HMG - CoA reductase inhibitors
  2. Bile acid sequestrants
  3. Nicotinic acid
  4. Fibric acid derivates
  5. Others
    a. Cholesterol absorption inhibitor
    b. Lipid - regulating agent
83
Q

HMG-CoA

A

3-hydroxy-3-methylglutaryl coenzyme A / hydroxymethylglutaryl-CoA

84
Q

STATINS or HMG - CoA REDUCTASE INHIBITORS
Mechanism Of Action

A

Statins act by inhibiting the enzyme HMG - CoA
reductase, the enzyme controlling the first committed step
of cholesterol synthesis in the liver

85
Q

Drug examples of Statins

A
  • Rosuvastatin
  • Atorvastatin
  • Simvastatin
  • Lovastatin
  • Pravastatin
  • Fluvastatin
86
Q

Adverse effects of Statins

A
  1. Hepatotoxicity
  2. Myositis
  3. Rhabdomyolysis
  4. GI symptoms: dyspepsia, constipations & abdominal pain
87
Q

Drug Interactions in Statins

A
  • Gemfibrozil (increase risk of rhabdomyolysis)
  • Lovastatin & Rosuvastatin (may prolong bleeding time with
    warfarin)
  • Increase muscular toxicity with drugs that inhibit CYP450
    3A4 system (cyclosporine, erythromycin, calcium blockers,
    niacin, ketoconazole)
88
Q

RESINS or BILE ACID SEQUESTERANTS
Mechanism Of Actions

A

They bind bile acids in the intestine through anion
exchange; this reduces the enterohepatic recirculation of
bile acids, which releases feedback regulation on
conversion of cholesterol to bile acids in the liver

89
Q

Drug examples of Resins

A
  • Cholestyramine
  • Colestipol
  • Colesevelam

Large nonabsorbable polymers that bind bile acids and
similar steroids in the intestine and prevent their
absorption.

90
Q

Resins aka

A

Bile acid sequestrants

91
Q

Statins aka

A

HMG-CoA reductase inhibitors

92
Q

Advantage of Resins

A

A strong safety record (not absorbed from GI so
lack of systemic toxicity)

93
Q

Disadvantage of Resins

A

Unpleasant granulated texture of powder
old resins

94
Q

Adverse Effects of Resins

A

Gl: constipation, bloating, epigastric fullness, nausea &
flatulence (specially with old ones)

95
Q

Drug Interaction in Resins

A

GI binding can reduce absorption of anionic drugs
(warfarin, thyroxin, digitoxin, beta - blockers & thiazide
diuretics

96
Q

NIACIN, NICOTINIC ACID or VITAMIN B3

A

Inhibit the mobilization of free fatty acids from peripheral
adipose tissue to the liver which reduces synthesis &
secretion of VLDL particles by the liver.

97
Q

Functions after conversion to nicotinamide adenine
dinucleotide (NAD) in the NAD coenzyme system.
Through multiple actions, niacin (but not nicotinamide)
reduces LDL cholesterol, triglycerides, and VLDL and also
often increases HDL cholesterol

A

Niacin, Nicotinic acid, or Vitamin B3

98
Q

3 Preparations in Niacin

A
  1. Immediate release: crystalline form: Causes flushing
  2. Sustained release: less flushing but maximum dose 2 gm
    to prevent liver toxicity
  3. Extended release: New drug, Niaspan is extended
    release formula better than other forms due to less side
    effects
99
Q

Adverse effects of Niacin

A
  • Flushing & headache
  • Increase blood glucose by 10-20 %
  • Hepatotoxicity
  • Niaspan: is the best, less flushing but more Gl effects that
    can be reduce if given with food. Less hepatic toxicity in
    doses ≤ 2gm / day
100
Q

Drug examples of FIBRIC ACID or DERIVATIVES (FIBRATES)

A
  • Gemfibrozil (600mg once or twice daily) taken with food
  • Fenofibrate (Tricor) 48mg one to three tablets daily
101
Q

FIBRIC ACID or DERIVATIVES (FIBRATES)
Mechanism Of Action

A

Increases activity of Peroxisome proliferator - activated
receptor - alpha (PPARa), this increases synthesis of
lipoprotein lipase therefore increasing clearance of
triglycerides.

102
Q

Adverse Effects of Niacin

A
  • Gl symptoms like nausea, dyspepsia & abdominal pain
  • Myositis & rhabdomyolysis: more common with gemfibrozil specially combination with statins
  • Cholelithiasis (Gallstones)
103
Q

A prodrug that is converted in the liver to the active
glucuronide form

A

EZETIMIBE or CHOLESTEROL ABSORPTION INHIBITOR

104
Q

Monotherapy or in combination with statin

A

EZETIMIBE or CHOLESTEROL ABSORPTION INHIBITOR

105
Q

Not recommended with fibrates

A

EZETIMIBE or CHOLESTEROL ABSORPTION INHIBITOR

106
Q

Reduces LDL number

A

EZETIMIBE or CHOLESTEROL ABSORPTION INHIBITOR

107
Q

Also used in phytosterolemia, a rare genetic disorder that
results from impaired export of phytosterols.

A

EZETIMIBE or CHOLESTEROL ABSORPTION INHIBITOR

108
Q

Adverse Effects of Ezetimibe

A
  • Diarrhea
  • Cough
  • Fatigue
109
Q

Only FDA approved supplement for tx of dyslipidemia

A

OMEGA 3 or LIPID REGULATING AGENT

110
Q

Decreases hepatic production of TG and VLDL

A

OMEGA 3 or LIPID REGULATING AGENT

111
Q

Omega 3 Fish oil (salmon, herring, mackerel, swordfish,
albacore tuna, sardines, lake trout)

A
  • Salmon
  • Herring
  • Mackerel
  • Swordfish
  • Albacore tuna
  • Sardines
  • Lake trout
112
Q

Omega - 3 fatty acids are:

A
  • Alpha - linolenic acid (ALA) acid
  • Eicosapentaenoic (EPA)
  • Docosahexaenoic acid (DHA)
113
Q

Drug examples of NEWER AGENTS or DRUGS UNDER INVESTIGATION

A
  • CETP inhibitors (cholesteryl ester transferring protein )
  • Torcetrapib
  • Anacetrapib
114
Q

Atorvastatin Reduction in LDL and Brand name

A

(Lipitor)
10 mg = 39%
80 mg = 51%

115
Q

Fluvastatin Reduction in LDL and Brand name

A

(Lescol)
40 mg = 25%
80 mg= 31%

116
Q

Lovastatin Reduction in LDL and Brand name

A

(Mevacor, generic)
40 mg = 31%
80 mg = 37%

117
Q

Pravastatin Reduction in LDL and Brand name

A

(Pravachol)
40 mg = 34%
80 mg = 40%

118
Q

Rosuvastatin Reduction in LDL and Brand name

A

(Crestor)
10 mg = 39%
40 mg = 57%

119
Q

Simvastatin Reduction in LDL and Brand name

A

(Zocor)
20 mg = 35%
80 mg = 47%

120
Q

Bile acid binders Reduction in LDL and Brand name

A

(Colestid, WelChol)
15%-30%

121
Q

Ezetimibe Reduction in LDL and Brand name

A

(Zetia)
15%-20%

122
Q

Fibrates Reduction in LDL and Brand name

A

(Lopid, Tricor, and others)
4%-30%

123
Q

Niacin Reduction in LDL and Brand name

A

(Niaspan, generic)
5%-25%

124
Q

OMEGA 3 aka

A

Lipid regulating agent

125
Q

Ezetimibe aka

A

Cholesterol absorption inhibitor

126
Q

Niacin aka

A

Nicotinic acid or Vitamin B3

127
Q

Fibric acids aka

A

Derivates (Fibrates)

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