Treatment Of Dyslipidemia

Question 1

What’s the name of bile acid sequestration drugs?

Answer 1

Resins
Suffix col (cholestyrmine, colsevelam, colstipol)

Question 2

What’s the MOA resins?

Answer 2

o Bile acids (cholesterol metabolites): 95% reabsorbed in the jejunum and
ileum
o In the presence of binding resins: excretion increases up to 10X
o Increased bile acid clearance causes increased conversion of cholesterol to
bile acids in the liver.
o A compensatory increase in the high-affinity LDL receptors increases
the removal of LDL from the blood.
o Little effects on HDL and/or triglycerides

Question 3

Clinical use of resins?

Answer 3

patients with hypercholesterolemia
Reduce pruritus in patients with cholestasis and bile salt accumulation (Obstructive
jaundice).

Question 4

Toxicity of resins?

Answer 4

BUSD(Y)

Question 5

What’s the name of drug of reducing cholesterol absorption

Answer 5

Ezitmibe

Question 6

MOA of Ezitmibe

Answer 6

Prodrug converted in the liver to active glucuronide form.
• Prevents GIT uptake of dietary cholesterol selectively and prevents its absorption&raquo_space;> reduce
cholesterol up to 18%.
• Compensatory increase in the high affinity LDL receptors increases the removal of LDL from the
blood.

Question 7

Toxicity of Ezitmibe?

Answer 7

When combined with HMG-CoA reductase inhibitors, increased risk of liver toxicity and dysfunction
» F/U liver function test (LFT)
واحد يصنع وواحد يوقف التصنيع وهذا الشيء بيخرب الكبد

Question 8

What’s the name of prodrugs of HMG-CoA Reductase Inhibitors?

Answer 8

Simvastatin, lovastatin
Inactive drugs that need to be activated

Question 9

What’s the name of active drugs of HMG-CoA Reductase Inhibitors?

Answer 9

Atorvastatin, Pravastatin, and Pluvastatin (Lescol)
Suffix statin

Question 10

MOA of Reductase inhibitors?

Answer 10

Lower cholesterol by inhibiting the enzyme HMG-CoA reductase, which is the
rate-limiting enzyme of the mevalonate pathway of cholesterol synthesis in the liver

And the same way the liver responds
Direct anti-atherosclerotic effect.
Prevent bone loss.

Question 11

Toxicity of HMG CO A?

Answer 11

H M G CoA R

Question 12

recommendations for statins drugs
Means the HMG CoA?

Answer 12

Contraindications in pregnancy lactation
Cyp450 تقلل من التكسير وتزيد سمية الأدوية
Recommend to give at bed time لان الكولسترول بيكون عالي بالليل

Question 13

What’s the name of ferric acid drugs?

Answer 13

Gemfibrozil, Fenofibrate, Clofibrate
Suffix fibrate

Question 14

MOA of fibrates

Answer 14

Increase lipoprotein triglyceride lipolysis through activation of lipoprotein lipase activity
Reduce serum triglyceride levels

Question 15

Clinical use of fibrates

Answer 15

Hyper triglyceride Mia VLDL predominant??
Dysbetalipoproteinemia

Question 16

Toxicity of fibrates

Answer 16

GAMS
A
S

Question 17

MOA of niacin B3

Answer 17

Inhibition of lipolysis عدم التكسير راح يمنع وصول الفات إلى الكبد عشان يستفيد منه وينزله في هيئة VLDL
بالتالي راح تنقص أشياء كثيرة
Low VLDL secretion
low LDL production
Low cholesterol synthesis
راح تقل الجلسريدات بالدم لأنها أصلاً ما تكسرت
وHigh HDL
Increased VLDL clearance by lipoprotein lipase???

Question 18

Clinical use of b3

Answer 18

Wide clinical use in the treatment of hyperlipidemia (hypertriglyceridemia) but in combination with other drugs.

Question 19

Toxicity of B3?

Answer 19

Cutaneous vasodilation> warmth> hypotension
Acanthosis (black area around the neck)
Contraindications for diabetes and severe septic conditions
Hyperuricemia goat may occur

Question 20

What’s - PCSK9 Inhibitors?

Answer 20

PCSK9 inhibitors are a new class of drugs that lower LDL level.
Very expensive.
The last choice when the other modalities didn’t work.