Pharmacology Of Dyslipidaemias

Question 1

HDL transport

Answer 1

Return of cholesterol from peripheral tissues to liver

Question 2

LDL transport

Answer 2

Return of cholesterol from liver to non-hepatic tissue

Question 3

VLDL transport

Answer 3

Return of cholesterol from liver to non-hepatic tissue

Question 4

Exogenous pathway

Answer 4

Transport tissue/liver

Question 5

Endogenous pathway

Answer 5

Transport of TGL to tissues. Mainly VLDL form.

Question 6

Hyperlipidaemia

Answer 6

Elevation in serum lipids

Increased CHD risk

Question 7

Type IIb

Answer 7

Familial combined/mixed hypercholesteraemia

Question 8

Type IV

Answer 8

Familial hypertroglyceridemia

Question 9

Statins

Answer 9

Simvastatin
Atorvastatin
Fluvastatin
Lovastatin
Pravastatin
Rosuvastatin

Question 10

Inhibitors of cholesterol absorption

Answer 10

Cholestyramine

Ezetimibe

Question 11

Nicotinic acid

Answer 11

Niacin

Acipimox

Question 12

Fibrates

Answer 12

Benzofibrate
Fenofibrate
Gemfibrozil

Question 13

Statin inhibitors 5 steps

Answer 13

Acetyl CoA
HMG CoA
Mevalonate
IPP
Squalene
Cholesterol

Question 14

Absolute contraindication of statins

Answer 14

Renal insufficiency

Question 15

Statins

Adverse effects

Answer 15

Myalgia

Rhabdomyolysis

Question 16

Statins

1. Main biochemical effect
2. Secondary biochemical effect

Answer 16

1. Reduced plasma LDL

2. Reduced TAG and increased HDL

Question 17

Simvastatin

Answer 17

Familial hypercholesteraemia
Absorption not influenced by food
Extensive liver metabolism

Question 18

Atorvastatin

Answer 18

Similar to simvastatin but longer acting

Mane/nocte

Question 19

Fluvastatin

Answer 19

More likely to cause hepatic reactions

Question 20

Lovastatin

Answer 20

Similar to simvastatin

Question 21

Pravastatin

Answer 21

No interactions with CYP450 enzyme inhibitors

Question 22

Rosuvastatin

Answer 22

Only drug used in children < 8 yo

Question 23

Fibrates

1. Mechanism of action
2. Clinical use and indications

Answer 23

1. Regulates gene expression
   Stimulates lipoprotein lipase
2. Mixed dyslipidaemia

Question 24

Bezafibrate

Answer 24

Caution in renal or hepatic failure or primary biliary cirrhosis

Question 25

Fenofibrate

Answer 25

May cause haemolysis in G6PD deficiency

Question 26

Gemfibrozil

Answer 26

May cause transient leukopenia

Question 27

Cholestyramine

Drug interactions

Answer 27

Fat soluble vitamins 
Warfarin
Digoxin
Thiazide
Tetracyclines
Barbiturates

Question 28

Ezetimibe

Mechanism

Answer 28

Lowers plasma cholesterol

Question 29

Niacin

Answer 29

Can reduce LDL 10% - 20%

Can increase HDL 30%

Question 30

Niacin

Adverse effects

Answer 30

Cutaneous flushing
Pruritis
Impairment of glucose tolerance

Question 31

Acipimox

Answer 31

Not diabetogenic

Question 32

Target values

Answer 32

LDL < 3
TAG < 1.7
HDL > 1.2