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Pharm II Final > Treatment of Lipid Disorders > Flashcards

Treatment of Lipid Disorders Flashcards

1
Q

What is hypertriglyceridemia?

A

Elevated triglycerides >150 mg/dL

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2
Q

What does cholesterol make?

A

Cell membranes
Organelle membranes
Adrenocortical hormones
Estrogen and testosterone

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3
Q

What cholesterol levels puts a patient at risk for cardiovascular disease?

A

Elevated plasma levels of total cholesterol and LDL, and/or Low levels of HDL

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4
Q

What controls the plasma cholesterol concentration?

A

Plasma cholesterol concentration controlled by plasma LDL concentration

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5
Q

What are some causes of hypercholesterolemia?

A

Diet
Lack of insulin or thyroid hormone
Genetic disorder

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6
Q

What are the NIH guidelines for healthy cholesterol levels?

A

Total cholesterol 60 mg/dL

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7
Q

What are the primary treatments for hypercholesteremia?

A

Dietary regulation
Weight reduction
Exercise

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8
Q

What are the actions of statins?

A

Lowers LDL concentration while increasing HDL concentration
Decreases oxidative stress and vascular inflammation
Stabilizes atherosclerotic lesions

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9
Q

What is the mechanism of action of statins?

A

HMG-CoA reductase inhibitors (prevents conversion of cholesterol)

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10
Q

What are the major side effects of statins?

A

GI upset, fatigue, headache
Hepatic Dysfunction
Myopathy
Rhabdomyolysis (rare)

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11
Q

How can statins effect coagulation in patients taking anticoagulants?

A

PT can be increased in pts taking warfarin

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12
Q

What does Niacin do to help patients with hyperlipidemia?

A

Inhibits synthesis of VLDLs
Inhibits release of free fatty acids from adipose tissue
resulting in a decrease in LDLs and triglycerides and increased HDLs

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13
Q

How can statins induce myopathies?

A

From medication interaction with amiodarone or verapamil

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14
Q

How does niacin affect blood glucose levels in a healthy individual?

A

It can cause hyperglycemia and abnormal glucose tolerance in nondiabetic patients

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15
Q

What causes the cutaneous flushing seen with large doses of niacin administration?

A

Intense prostaglandin-induced cutaneous flushing

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16
Q

How does niacin affect the use of antihypertensives?

A

Prostaglandin release causes exaggerated vasodilation therefore possible potentiation of antihypertensives

17
Q

What is a bile acid binding resin?

A

Chloride salt of an ion exchange resin

18
Q

What is the mechanism of action of bile acid binding resins?

A

Resins bind bile acids in intestines, increase fecal excretion, and increase hepatic bile acid synthesis from cholesterol stores
Results in more LDL receptors = increased uptake and decreased plasma concentrations

19
Q

What is a drawl back to utilizing acid bile resins?

A

Poor palatability

20
Q

What metabolic disturbance may be seen in patients that use acid bile resins?

A

Hyperchloremic acidosis

21
Q

What drug’s absorption may be impaired by acid bile resins?

A

Thiazides, warfarin, digitalis, beta blockers

22
Q

In order to avoid drug interactions, when should other drugs be given in combination with acid bile resins?

A

Other drugs should be given 1 hr before or 4 hrs after

23
Q

What is the mechanism of action of fibrates?

A

Drug-induced increases in activity of lipoprotein lipase

24
Q

When are vibrates indicated?

A

Most effective drugs for decreasing plasma triglycerides

Increase HDL, variable effects on LDL

25
Q

How might fibrates affect patients taking anticoagulants?

A

They can potentiate anticoagulant effect of warfarin

26
Q

How do omega-3 fatty acids affect patients with hyperlipidemia?

A

Decreases plasma levels of triglycerides but no significant effects on HDL/LDL

27
Q

Why is it important to know that omega-3 fatty acids are not considered drugs?

A

Not regulated by FDA

Safety of long term use unknown

28
Q

How do omega-3 fatty acids affect bleeding during surgery?

A

Patients seem to be more oozy or at an increased risk for bleeding

Pharm II Final (12 decks)

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