Pharm: Hyperlipidemia Flashcards

1
Q

4 leading conditions associated with secondary (acquired) dyslipidemia

A
  1. Diabetes Mellitus (both types)
  2. HYPOthyroidism
  3. Cholestatic Liver Disease
  4. Nephrotic Syndrome
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2
Q

What HDL level measured on lipid panel can act as a negative risk factor for high cholesterol?

A

> 60 mg/dL

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3
Q

What are 4 Pleiotropic (when 1 thing has an influence on multiple other things) effects of statin therapy in people with high cholesterol?

A
  1. Decreased Inflammation
  2. Decreased endothelial dysfunction
  3. Decreased Thrombus formation
  4. More stable atherosclerotic plaque
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4
Q

What are the desireable or optimal levels for: Total cholesterol, LDL, HDL, and TGs according to the ATP (Association of Tennis Professionals) III classification.

A
Adult Treatment Panel (ATP)
Total < 200
LDL < 100
HDL > 60
TGs <150
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5
Q

Mechanism of Statins

A

Inhibit HMG-CoA reductase inhibiting endogenous cholesterol production.

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6
Q

Which 3 statins are the most effective at lowering HDL?

A

Pitavastatin
Rosuvastatin
Atorvastatin

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7
Q

What levels of total cholesterol, LDL, HDL, and TGs are considered high cholesterol according to the ATP III classification?

A

Total > 240 mg/dL
LDL > 160
HDL < 40
TGs >200

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8
Q

Fenofibrate

A

MOA: fibric acid derivative that increases LPL and Apo E production to lower TGs, LDL, raises HDL.

Use: Type III hyperlipidemia

Contraindications: caution with statins, gallbladder, hepatic, or renal disease

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9
Q

Gemfibrozil

A

MOA: fibric acid derivative that increases LPL and Apo E production to lower TGs, raises HDL. (less effective at lowering LDL so Fenofibrate is better)

Use: Type III hyperlipidemia

Contraindications: caution with statins, gallbladder, hepatic, or renal disease

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10
Q

Lovaza

A

MOA: omega-3-acid ethyl ester that inhibits liver cholesterol production. Supplement approved to lower TGs and raise HDL.

Simlar to Omega 3 fish oil.

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11
Q

Ezetimibe (Zetia)

A

MOA: Inhibits NPC1L1 lipid transporter to prevent absorption of cholesterol at the small intestine brush border.

Use: mainly decreases LDL, moderate increase in HDL

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12
Q

Colestipol

A

MOA: bile acid binding resin preventing reabsorption of bile salts

Use: high cholesterol in combination with niacin.

Adverse Effects: constipation, bloating

Containdications: familial hypercholesterolemia (no functioning LDL receptors).

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13
Q

Cholestyramine

A

MOA: bile acid binding resin preventing reabsorption of bile salts

Use: high cholesterol in combination with niacin.

Adverse Effects: constipation, bloating

Containdications: familial hypercholesterolemia (no functioning LDL receptors).

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14
Q

Colesevelam

A

MOA: bile acid binding resin preventing reabsorption of bile salts

Use: high cholesterol in combination with niacin.

Adverse Effects: constipation, bloating

Containdications: familial hypercholesterolemia (no functioning LDL receptors).

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15
Q

Niacin/Nicotinic Acid

A

MOA: Raises HDL, moderately lowers LDL

Use: high cholesterol, Gout (combined with allopurinol)

Adverse Effects: acanthosa nigrans, skin flushing

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16
Q

Coenzyme Q10

A

MOA: component of the electron transport chain that is made from cholesterol

Use: prevent mitochondrial dysfunction when using statins

17
Q

How does Garlic help with high cholesterol?

A

Inhibits HMG-CoA reductase
Antiplatelet activity
Enhanced fibrinolytic activity
Antioxidant properties

18
Q

Psyllium

A

MOA: bulk stool forming laxative, prevents reabsorption of components from feces including cholesterol

19
Q

What are the:
Goal Levels
Therapeutic Lifestyle Change Levels
Drug therapy levels

recommended by ATP III regarding high cholesterol. High risk, moderately high, moderate,low.

A

High:
Goal 100
DT > 100

Moderately High
Goal < 130
TLC > 130
DT > 130

Moderate
Goal < 130
TLC > 130
DT > 160

Low
Goal < 160
TLC > 160
DT > 190