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Cardiology > Treatment of Dyslipidemias > Flashcards

Treatment of Dyslipidemias Flashcards

1
Q

What dietary factors are used in Tx of Dyslipidemias?

A 
Mediterranian Diet
Fresh Fruit and Veggies 
Whole Grains 
Fatty Fish
Lean Meats 
Higher fat dairy products
Nuts

Eat the fruits and veggies first
More satiating stuff afterward
Dietary cholesterol

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2
Q

What is the contribution of exercise in Tx of dyslipidemias?

A 
Increase CV fitness 
Decreases LDL increases HDL
Decreases TRGs 
30-40 min 3-4x per week.
Even if they don't change in weight.
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3
Q

What are the alcohol factors for Tx of dyslipidemias?

A

1-2 drinks are supposedly benificial

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4
Q

What is the Tx for Familial Chylomicronemia?

A

Diet

Creamy top layer

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5
Q

What is the Tx for Familial Hypercholesterolemia?

A

Cholestyramine or Cholestipol, statins, niacin

Clear

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6
Q

What is the Tx for Familial Combined Hypercholesterolemia?

A

Statins, Niacin, Fibrates

Clear

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7
Q

What is the Tx for Familial dysbetalipoproteinemia?

A

Fibrates, Statins

Turbid

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8
Q

What is the Tx for Familial Hyperlipemia?

A

Statins, Niacin, Fibrate

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9
Q

What is the Tx for Endogenous hypertriglyceridemia?

A

Niacin, Fibrate

Creamy top Tubid bottom

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10
Q

What will cause a Creamy top layer appearance of serum?

Turbidity?

A

High chylomicrons.

High LDLs

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11
Q

What are the visible signs of FH?

A 
Xanthelasma
Corneal arcus
Ach Tendon Xanthoma
Tendon Xanthoma
Tuberous Xanthomas
Palmar Xanthomas
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12
Q

What are the medical therapies for FH?

A

Statins

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13
Q

What is the MOA of Statins?

A

HMG - Co A reductase Inhibitor
Reduces serum cholesterol concentration
Reduces CV events AND MORTALITY!

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14
Q

What is the mechanism of benefits of Statins?

A 
Reg of AS
Plaque stabilization
Red Inflammation
Dec Thrombogenicity
Reversal of Endothlial Dys
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15
Q

What are the 4 reccomended groups in statin therapy?

A

1) Secondary Prevention-clinical ASCVD
HIT to MIT
2) Primary Prevention-primary LDL>190 mg/dL
HIT
3) Primary Prevention- Diabetics LDL 70 to 189
MIT or HIT
4) PRimary Prevention- No diabetes but 10 yr CVD risk >7.5% 40 to 75yo
MIT or HIT

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16
Q

What are the Low
Medium and
High Intensity Statins?

A

Low: PRavastatin, Lovastatin
Med: Atorva, Rosuva, Simva, Prava,Lovastatin
High:Atorva, Rosuvastatin

17
Q

What are the AA of Statins?

A

Diabetes(insulin resistance)
Muscle: Rhabdomyolysis(CK), Caused by depleted Q10?
GEMFIBROZIL has higher risk of muscle complaints
Hepatic
CNS-memory loss
GI-loose stools

18
Q

What are the categories of Statin muscle complaints?

A 
Myalgia
Myopathy
Myositis
Myonecrosis
Rhabdomyolysis
19
Q

What is Statin triggered autoimmune myopathy?

A

Weakness doesnt resolve and CK remains elevated despite discontinuation
anti-HMGCR autoantibody
Tx with immunosupressives(IVIG) prednisone

20
Q

What are non statin lipid lowering treatments?

A

Bile acid Sequestrants
Nicotinic acid
Fibric Acids
Eztimibe

21
Q

What is the MOA of Bile acid Sequestrants?

A

Keeps bile acids from being reabsorbed
Forces the body to use its own cholesterol to make more.
May increase TRGs

22
Q

What is the MOA of Nicotinic acid?

A

Raises HDL
Reduced LPa
SA Flushing, hyperglycemia, gout
No reduction in events :-(

23
Q

What is the MOA of Fibrates?

A 
Used for hyper triglyceridemia
Lower TG
Causes GALLSTONES, dyspepsia, myopathy
Doesn't benefit T2 Diabetics or those taking statins
(DONT TAKE WITH STATINS!)
24
Q

What is the MOA of Ezetimibe?

A

Impairs dietary and biliary cholesterol abs without affecting TG or FSV.
When used with a stain will increase benefit

25
Q

What OTC and Dietary supps can be used?

A 
Fish oil (reduces TRGs)
Soy
Garlic
Red Yeast rice
Chol lowering Margarines (bind to cholesterols)
Add Soluble fiber to diet
26
Q

What are med and Comorbid disease effects on lipids?

A 
Meds:Thiazides
Estrogen
B Blockers
Steroids
Protease Inhibitors
Comorbidities:
Very high LDL
Elevated TRG
Diabetes Mellitus
27
Q

What are the CETP Inhibitors?

A

Anacetrapib

Lots have been removed for SA and most dont decrease risk of events!

28
Q

Options for Homozygous FH?

A

Mipomersen: Blocks Transcription/ translation of Apo B lipoprotins
Lomitapide: MTP inhibitor
Prevents assembly and secretion of Apo B

29
Q

What are the PCSK 9 molecules?

A

Locks action of LDL receptors
Reduces LDL
So far no dose limiting toxicities

Cardiology (22 decks)

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