Pharmacology - Chapter 49 - Prophylaxis of Coronary Artery Disease - Drugs used to Lower Cholesterol Levels Flashcards
CAD - starts with….then what?
development of a fatty streak in arterial wall, followed by deposition of fibrous plaque. As plaque grows it begins to occlude artery, blocks blood flow, and causes angina. It may lead to thrombi leading to MI!!!!
Risk of CAD directly related to levels of ___ cholesterol in blood.
LDL
Cholesterol - component of all ___ membranes.
Cell.
What are some of the things that cholesterol does?
Forms cell membranes, synthesizes hormones (like sex hormones) and others.
Cholesterol comes from…
liver cells.
What catalyzes the synthesis of cholesterol?
Hydroxymethylgutaryl Coenzyme A (HMG CoA)
Give cholesterol lowering drugs in the morning. T/F?
FALSE - give them at night!
What are plasma lipoproteins?
Carriers for transporting lipids cholesterol and triglycerides in the blood.
What do apolipoproteins?
They serve as recognition sites for cell surface receptors.
1, A-2 - deliver cholesterol to ____.
b-100 - deliver cholesterol to ____.
Non-hepatic/hepatic.
What are VLDL’s?
Very Low Density - Triglycerides.
LDL’s - what are they?
Bad cholesterol.
HDL - what are they?
High density - contribute to protection against CAD.
LDL - initiates and fuels development of…
Atherosclerosis.
Total Cholesterol Levels - should be…
<150 mg/dl
HDL Cholesterol - levels should be…..
> 40 mg/dl.
LDL - level should be……
<100 mg/dl.
Diet modification is not important for lowering cholesterol. T/F?
FALSE - it is very important!
What are the lipid lowering drugs? (5)
HMG CoA reductase inhibitors, Bile acid-binding resins, nicotinic acid, fibric acid derivatives (fibrates), estrogen.
What is an HMG CoA drug?
Lovastatin (Mevacor)
what does lovastatin do?
Lowers LDL (increasing LDL receptors in the hepatocytes), lowers VLDL, improves HDL.
What are some adverse effects of Lovastatin?
Headache, rash, and hepatotoxicity.
What is a Bile Acid-Binding Resin?
Cholestyramine (Questran.)
What does cholestyramine (questran) do?
It increases LDL receptors in the liver. It accelerates excretion/prevents absorption of bile acid.
What are some adverse effects of Cholestyramine (Questran) ?
Constipation, decreased absorption of fat soluble vitamins.
Nicotinic Acid - what does it do?
Decreases production of VLDL’s….
What are some adverse effects of Nicotinic acid?
Skin (flushing, itching), nausea, vomiting, gastric upset, hepatotoxicity, hyperglycemia.
Fibric Acid - what is the drug?
Gemfibrozil (Lopid)
What does gemfibrozil (lopid) do?
It lowers high triglyceride levels.
What are some adverse effects of gemfibrozil (lopid) ?
Rashes, gastrointestinal problems, gallstones, hepatoxicity.
Estrogen - in postmenopausal women, estrogen therapy reduces LDL cholesterol by ___ to ___ %, increases HDL cholesterol by __ to __ %.
15-25%/10-15%.
