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aDEMS unit 2- Lindseys > Statins > Flashcards

Statins Flashcards

1
Q

How do bile acid sequestrants work?

A
  • they reduce the enterohepatic circulation of bile acids
  • reduce LDL-C by increasing intrahepatic LDL receptors
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2
Q

Omega-3 FAs are only approved to treat pts with fasting TGs > _____.

A

500mg/dL

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3
Q

How do plant sterols and stanol esters work?

A

by preventing mixed micelle formation in the intestine –> reduce cholesterol absorption

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4
Q

By how much do fibrates lower TGs?

A

20-40%

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5
Q

Niacin raises HDL-C by _____%.

A

10-30%

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6
Q

When do you choose a high intensity statin?

A
  • LDL-C > 190
  • DMII
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7
Q

What are the SEs of fibrates?

A
  • raised serum creatinine
  • higher risk of myopathy
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8
Q

How does niacin work?

A

it decreases catabolism of apo A1 –> decrease synthesis of VLDL, LDL + increases HDL

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9
Q

What are bile acid sequestrants?

A
  • high molecular weight polymers that bind bile acids in the intestines in exchange for Cl-
  • neither absorbed nor metabolized
  • reduce the enterohepatic circulation of bile acids
  • reduce LDL-C by increasing intrahepatic LDL receptors
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10
Q

High dose omega-3 FAs or fish oils lower triglycerides by ______%.

A

15-35

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11
Q

These drugs work by by preventing mixed micelle formation in the intestine –> reduce cholesterol absorption.

A

plant sterols and stanol esters

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12
Q

What are the SEs of statins?

A
  • hepatic transaminase elevation
  • rhabdomyolysis
  • myopathy/myalgias
  • new onset DMII
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13
Q

What are the SEs of niacin?

A
  • flushing
  • rash
  • GI distress
  • hepatotox
  • myopathy
  • glucose intolerance
  • hyperuricemia
  • gout
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14
Q

By how much do fibrates raise HDL-C?

A

5-15%

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15
Q

What is combined hyperlipidemia?

A

increased LDL-C and increased TGs

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16
Q

What are the indications for initiation of a statin?

A
  • 2a prevention bc of high ASCVD risk
  • LDL-C > 190 with age > 21
  • 1a prevention in DMII age 40-75 and LDL-C btw 70-189
  • 1a prevention w/o DMII with ASCVD risk > 7.5% and age 40-75 with LDL-C 70-189
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17
Q

What is the major pharm. effect of omega-3 FAs and fish oils?

A

to reduce VLDL triglyceride production and secretion

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18
Q

By how much do PCSK9 inhibitors reduce LDL-C?

A

by 60%

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19
Q

By how much do bile acid sequestrants reduce LDL-C?

A

10-30%

20
Q

How are PCSK9 inhibitors administered?

A

sub-q every 2 weeks

21
Q

How do fibrates work?

A

by inducing PPARalpha-related gene expression –> increase intra-hepatic fatty acid oxidation –> reduce VLDL TG synthesis and secretion

22
Q

Name 2 high intensity statins.

A
  • atorvastatin
  • rosuvastatin
23
Q

Niacin lowers LDL-C by _____%.

A

5-25%

24
Q

These drugs work by inducing PPARalpha-related gene expression –> increases in intra-hepatic fatty acid oxidation –> reduction in VLDL TG synthesis and secretion.

A

fibrates

25
Q

What are the SEs for plant sterols and stanol esters?

A

none

26
Q

By how much do plant sterols and stanol esters reduce LDL-C?

A

by 5-10%

27
Q

When would you prescribe an Ezetimibe?

A

as an add-on therapy

28
Q

What are the SEs for Ezetimibe?

A

none

29
Q

What are the SEs for bile acid sequestrants?

A
  • nausea
  • bloating
  • constipation
  • bind to other medications
30
Q

This drug decreases catabolism of apo A1 –> a decrease synthesis of VLDL, LDL and increases HDL.

A

niacin

31
Q

These drugs inhibit HMG CoA reductase and increase LDL receptors, therefore increasing the uptake/catabolism of LDL.

A

statins

32
Q

This is a cholesterol lowering med that selectively inhibits cholesterol absorption.

A

Ezetimibe

33
Q

When would you prescribe PCSK9 inhibitors?

A

as adjuncts to diet and maximal statin therapy for pts with heterozygous familial hypercholesterolemia or atherosclerotic CV disease

34
Q

How do you lower LDL-C with meds?

A

statins/HMG CoA reductase inhibitors

35
Q

Name 2 low intensity statins.

A
  • pravastatin
  • lovastatin
36
Q

When very high triglycerides (TGs) are present (>1000mg/dL), there is a risk of _____.

A

pancreatitis

37
Q

______ lowers LDL-C and TG while raising HDL-C.

A

Niacin

38
Q

Niacin lowers TG by _____%.

A

15-35%

39
Q

How do statins reduce LDL-C?

A
  • inhibit HMG CoA reductase
  • increase LDL receptors and therefore uptake/catabolism of LDL
40
Q

When do you choose a moderate intensity statin?

A

ASCVD risk > 7.5%

41
Q

What are the SEs for PCSK9 inhibitors?

A
  • injection site rxns
  • drug-induced Abs
  • allergies
  • neurocognitive events
42
Q

What is Ezetimibe?

A

a cholesterol lowering med that selectively inhibits cholesterol absorption

43
Q

When would you prescribe fibrates?

A
  • as 2a prevention + a statin for DMII pts
  • pts with existing ASCVD who are hypertriglyceridemic and have low HDL-C
44
Q

These are cholesterol meds that are high molecular weight polymers that bind bile acids in the intestines in exchange for Cl- and are neither absorbed nor metabolized; they reduce the enterohepatic circulation of bile acids- they reduce LDL-C by increasing intrahepatic LDL receptors.

A

bile acid sequestrants

45
Q

When would you prescribe a bile acid sequestrant?

A
  • as an add-on therapy if statin isn’t tolerated
  • in pregnancy

aDEMS unit 2- Lindseys (7 decks)

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