Quiz 3

Question 1

Does a drug to decrease LDL

Answer 1

Simvastatin 20-40mg at night

Question 2

Dose a drug that increases HDL significantly and helps decrease TG

Answer 2

Gemfibrizol 600mg 2x daily

30min before breakfast and dinner

Question 3

Dose a drug that decreases TG and doesn’t interfere with a HMG-CoA reductase inhibitory

Answer 3

Slo-Niacin 500mg-1g at night

Question 4

Define hyperlipidemia

Answer 4

Elevation in any lipoprotein species

Question 5

Define hyperlipemia

Answer 5

Increased levels of triglycerides

Question 6

Chylomicrons carry

Answer 6

They are very large, they carry dietary lipids

Question 7

VLDL carry

Answer 7

triglycerides and to a lesser extent cholesterol

Question 8

IDL carry

Answer 8

cholesterol esters and triglycerides

Question 9

LDL carry

Answer 9

cholesterol esters to tissues/vessels

Question 10

HDL carry

Answer 10

cholesterol esters from plaques and tissues to liver

Question 11

What apoproteins convey lipids into the tissue and artery walls?
What lipoproteins have them?

Answer 11

B-100 & B-48

-VLDL, IDL, LDL, chylomicrons

Question 12

What apoproteins is unique to HDL?

Answer 12

D

Question 13

What lipoprotein reduces the risk of CHD?

Answer 13

HDL

Question 14

Healthy adults over age____ should receive a lipid panel every_______
Obtained after a ________ hour fast

Answer 14

Over age 20, every 5 years

after 9-12hr fast

Question 15

What is in the lipid panel?

Answer 15

Total Cholesterol (TC)
Triglycerides
HDL
LDL & VLDL are calcuated

Question 16

VLDL=

Answer 16

Triglycerides/5

Question 17

LDL=

Answer 17

TC- (HDL+VLDL)

Question 18

Causes of secondary “acquired” hyperlipidemia

Answer 18

Diabetes
Hypothyroidism
Renal Failure
Obstructive liver disease
Drug induced

Question 19

What guidelines do we use to establish dyslipidemia treatment goals?

Answer 19

ATP III Cholesterol Guidelines

Question 20

What factors are considered when evaluating CHD risk

Answer 20

Clinical CHD
Symptomatic carotid artery disease
Peripheral artery disease
abdominal aortic aneurysm
diabetes

Question 21

What are the major risk factors?

Answer 21

Smoking
HTN
HDL <60
Familial hx premature CHD

Question 22

What factors are used to calculated Framingham risk score?

Answer 22

Age
TC
HDL
Smoking status
Systolic BP

Question 23

ADRs of HMG-CoA reductase inhibitors

Answer 23

Myopathy

-re-challenge with another or smaller dose

Question 24

What enzyme metabolizes Simvastatin?

Answer 24

CYP3A4

Question 25

MOA for statins

Answer 25

Reduces hepatic cholesterol biosynthesis

Question 26

Metabolic Syndrome looks at what risk factors?

Answer 26

``` Abdominal obesity Triglycerides HDL BP Fasting Glucose ```

Question 27

IF triglycerides are >________ first lower triglycerides vs. LDL to prevent______ Use a ____

Answer 27

>500 pancreatitis Use fibrate or nicotinic acid

Question 28

Initial treatment of choice for hyperlipidemia

Answer 28

Therapeutic Lifestyle Changes (TLC) - weight management - physical activity - TLC diet - Smoking cessation - Manage comorbidities

Question 29

Other benefits of statins include:

Answer 29

decrease oxidative stress decrease vascular inflammation stabilize atherosclerotic lesions

Question 30

MOA of nicotinic acid

Answer 30

Decrease hepatic VLDL secretion and enhances VLDL clearance

Question 31

ADRS of niacin include

Answer 31

``` Flushing, pruritus, warmth, tingling Hyperglycemia Hyperuricemia=gout Upper GI distress Hepatotoxicity ```

Question 32

Drug interactions of Niacin include

Answer 32

Bile-acid binding resins decrease absorption | Enhances ADRs or statins

Question 33

MOA of fibrates

Answer 33

Activate lipoprotein lipase Promote delivery of TGs to adipose Interfere with VLDL formation in the liver

Question 34

Fibrate with Clcr <80-30mL/min=

Answer 34

Adjust dose

Question 35

Fibrate with Clcr <=30

Answer 35

Contraindicated

Question 36

ADRs of Fibrates

Answer 36

Rare but: - GI symptoms - Myopathy - Arrhythmias - Increased aminotransferases or alk phos

Question 37

Drug interactions of fibrates include

Answer 37

Increase myopathies when with statins | Increased warfarin affect

Question 38

OTC Fish Oil/Omega 3 fatty acids may

Answer 38

Decrease triglycerides

Question 39

Pregnant women/lactating can not receive

Answer 39

Statins (Category X)

Question 40

First drug choice for children

Answer 40

cholestyramine