WEEK 2 ANTILIPEMICS Flashcards

1
Q

Describe the action of HMG-CoA reductase inhibitors

A

Inhibits HMG-CoA reductase, a key enzyme in endogenous cholesterol synthesis, restricting lipoprotein production

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2
Q

What is the therapeutic effect of HMG-CoA reductase inhibitors?

A

Lowers total LDL cholesterol and triglycerides, slightly increases HDL cholesterol. Decreases plaque site inflammation and risk of thromboembolism.

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3
Q

Name 1 example of an HMG-CoA reductase inhibitor

A

Atorvastatin

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4
Q

Name 3 side effects of HMG-CoA reductase inhibitors

A
  1. Myopathy/rhabdomyolysis
  2. Hepatotoxicity/increased liver enzymes
  3. Peripheral neuropathy
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5
Q

Why should HMG-CoA reductase inhibitors be taken at night?

A

The liver produces the most cholesterol at night

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6
Q

What are 2 food/drug interactions with HMG-CoA reductase inhibitors?

A
  1. Fibrates
  2. Grapefruit
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7
Q

Describe the action of bile acid sequestrants

A

Binds bile acids in the GI tract, forming an insoluble complex, which is then cleared from the body

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8
Q

What is the therapeutic effect of bile acid sequestrants?

A

Decreased plasma cholesterol and LDL cholesterol

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9
Q

Name 1 example of a bile acid sequestrant

A

Cholestyramine

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10
Q

What time should bile acid sequestrants be taken?

A

1 hour before or 4 hours after other medications or vitamins (to prevent binding in GI tract)

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11
Q

When should bile acid sequestrants be held?

A

Bowel obstruction

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12
Q

What are 2 side effects of bile acid sequestrants?

A
  1. Constipation (take a fibre supplement)
  2. GI upset (take with meals)
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13
Q

Describe the action of nicotinic acid

A

Large doses decrease lipoprotein and triglyceride synthesis by inhibiting the release of free fatty acids from adipose tissue and decreasing hepatic lipoprotein synthesis

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14
Q

What is the therapeutic effect of nicotinic acid?

A

Adjunctive treatment (with bile acid sequestrants or fibrates) to decrease blood lipids

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15
Q

What are 3 side effects of nicotinic acid?

A
  1. Flushing (prevent with NSAIDs)
  2. Pruritis
  3. GI upset
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16
Q

What are 3 contraindications for nicotinic acid?

A
  1. Liver disease
  2. Hypertension
  3. Active bleeding
17
Q

Describe the action of cholesterol absorption inhibitors

A

Inhibits absorption of cholesterol in the small intestine

18
Q

What is the therapeutic effect of cholesterol absorption inhibitors?

A

Lowers cholesterol to lower the risk for atherosclerosis

19
Q

What is the name of the only cholesterol absorption inhibitor?

20
Q

Cholesterol absorption inhibitors should not be taken which which group of drugs?

21
Q

Describe the 3 actions of fibric acid derivatives (fibrates)

A
  1. Inhibits peripheral lipolysis
  2. Decreases triglyceride production by liver
  3. Decreases production of triglyceride carrier protein
22
Q

What is the therapeutic effect of fibrates?

A

Lowers triglycerides and increases HDL

23
Q

Name 1 example of a fibrate

A

Gemfibrozil

24
Q

When are fibrates used?

A

When patient not responsive to statins

25
What does fibrates not have an effect on?
LDL levels
26
What group of drugs should fibrates not be used with?
Statins
27
What drug should be used with caution in a patient on fibrates?
Warfarin, as fibrates bind to vitamin K which would normally inhibit warfarin
28
Name 2 side effects of fibrates
1. Gallstones 2. GI upset
29
Name 2 examples of platelet aggregation inhibitors
1. Aspirin 2. Clopidogrel
30
Describe the action of aspirin
Prevents platelet aggregation and vasoconstriction by blocking the production of thromboxane
31
Describe the action of clopidogrel
Prevents platelet aggregation by blocking adenosine diphosphate receptors on platelets