Summary Table of Drugs Used in Dyslipidemia

Question 1

Which drug: MOA

Inhibit HMG-CoA reductase

Answer 1

Statins

Question 2

Which drug: MOA

Peroxisome proliferator- activated receptor-alpha (PPAR-α) agonists

Answer 2

Fibrates

Question 3

Which drug: MOA

• Binds bile acids in gut
• prevents reabsorption
• increases cholesterol catabolism
• upregulates LDL receptors

Answer 3

Bile acid sequestrants

Question 4

Which drug: MOA

Blocks sterol transporter NPC1L1 in intestine brush border

Answer 4

Cholesterol absorption inhibitor

Question 5

Which drug: MOA

• Decreases catabolism of apo AI
• reduces VLDL secretion from liver

Answer 5

Niacin

Question 6

Which drug: MOA

Complexes PCSK9

Answer 6

PCSK9 humanized monoclonal antibodies

Question 7

Which drug: Effects

• Reduce cholesterol synthesis and upregulate low-density lipoprotein (LDL) receptors on hepatocytes
• modest reduction in triglycerides

Answer 7

Statins

Question 8

Which drug: Effects

• Decrease secretion of very- low-density lipoproteins (VLDL)
• increase lipoprotein lipase activity
• increase high- density lipoproteins (HDL)

Answer 8

Fibrates

Question 9

Which drug: Effects

Decreases LDL

Answer 9

Bile acid sequestrants

Question 10

Which drug: Effects

• Inhibits reabsorption of cholesterol excreted in bile
• decreases LDL and phytosterols

Answer 10

Cholesterol absorption inhibitor

Question 11

Which drug: Effects

• Increases HDL
• decreases lipoprotein(a) [Lp(a)], LDL

Answer 11

Niacin

Question 12

Which drug: Effects

Inhibits catabolism of LDL receptor

Answer 12

PCSK9 humanized monoclonal antibodies

Question 13

Which Drug: Clinical Applications

• Atherosclerotic vascular disease (primary and secondary prevention)
• acute coronary syndromes

Answer 13

Statins

Question 14

Which Drug: Clinical Applications

Hypertriglyceridemia, low HDL

Answer 14

Fibrates

Question 15

Which Drug: Clinical Applications

Elevated LDL, digitalis toxicity, pruritus

Answer 15

Bile acid sequestrants

Question 16

Which Drug: Clinical Applications

Elevated LDL, phytosterolemia

Answer 16

Cholesterol absorption inhibitor

Question 17

Which Drug: Clinical Applications

• Low HDL
• elevated VLDL, Lp(a); elevated LDL in statin- unresponsive or intolerant patients

Answer 17

Niacin

Question 18

Which Drug: Clinical Applications

Familial hypercholesterolemia not responsive to oral therapy

Answer 18

PCSK9 humanized monoclonal antibodies

Question 19

Which Drug: PK, Toxicities, Interactions

• Oral
• Duration 12-24 h
• Toxicity: Myopathy, hepatic dysfunction
• Interactions: CYP-dependent metabolism (3A4, 2C9) interacts with CYP inhibitors/competitors

Answer 19

Statins

Question 20

Which Drug: PK, Toxicities, Interactions

• Oral
• duration 3–24 h
• Toxicity: Myopathy, hepatic dysfunction

Answer 20

Fibrates

Question 21

Which Drug: PK, Toxicities, Interactions

• Oral
• taken with meals
• not absorbed
• Toxicity: Constipation, bloating
• interferes with absorption of some drugs and vitamins

Answer 21

Bile acid sequestrants

Question 22

Which Drug: PK, Toxicities, Interactions

• Oral
• duration 24 h

• Toxicity: Low
incidence of hepatic dysfunction, myositis

Answer 22

Cholesterol absorption inhibitor

Question 23

Which Drug: PK, Toxicities, Interactions

• Oral
• large doses
• Toxicity: Gastric irritation, flushing, low incidence of hepatic toxicity
• may reduce glucose tolerance

Answer 23

Niacin

Question 24

Which Drug: PK, Toxicities, Interactions

• Parenteral
• Cost ~ $14,000/year
• Toxicity: injection site reactions, nasopharyngitis, flu-like symptoms, rarely myalgia, neurocognitive and ophthalmologic events

Answer 24

PCSK9 humanized monoclonal antibodies