Week 6 Cholesterol Medications

Question 1

Atorvastatin

Answer 1

Lipitor

Cardiovascular

Cholesterol Lowering
Statin

Hyperlipidemia, Prevention of cardiovascular disease, familial hypercholesterolemia

myalgias, rhabdomyolysis, elevated LFTs, elevated blood glucose

No BBW, CI in pregnancy, caution in liver disease, diabetes, geriatric patients

Question 2

Ezetimibe

Answer 2

Zetia

Cardiovascular

Cholesterol Absorption Inhibitor

Hyperlipidemia, familial hypercholesterolemia, homozygous sitosterolemia
GI (diarrhea, bloating), upper respiratory tract infection
Fibrates, bile acid sequestrants

Moderate-severe liver impairment

Question 3

Ezetimibe/Simvastatin

Answer 3

Vytorin
Cardiovascular
Cholesterol Lowering
Cholesterol Absorption Inhibitor/Statin

Question 4

Fenofibrate

Answer 4

Lipofen

Tricor

Cardiovascular

Cholesterol Lowering

Fibrate

hypertriglyceridemia
GI (indigestion, diarrhea, constipation nausea), elevated LFTs, myopthy

Statins, cholesterol absorption inhibitors, warfarin

Caution in kidney dysfunction

Question 5

Lovastatin

Answer 5

Mevacor
Altoprev

Cardiovascular

Cholesterol Lowering

Statin

Hyperlipidemia, Prevention of cardiovascular disease, familial hypercholesterolemia

myalgias, rhabdomyolysis, elevated LFTs, elevated blood glucose

macrolides, CCBs, warfarin, gemfibrozil
No BBW, CI in pregnancy, caution in liver disease, diabetes, geriatric patients

Question 6

Niacin

RX and OTC

Answer 6

Niaspan Slo-Niacin

Cardiovascular

Cholesterol Lowering

Water-soluble vitamin

dyslipidemias, extreme triglyceride elevation

Flushing, edema, elevated BG, elevated uric acid, GI
bile acid seuestrants

Warning in liver disease, peptic ulcer disease, diabetes

Question 7

Pravastatin

Answer 7

Pravachol

Cholesterol Lowering

Statin

Hyperlipidemia, Prevention of cardiovascular disease, familial
hypercholesterolemia

myalgias, rhabdomyolysis, elevated LFTs, elevated blood glucose

gemfibrozil

No BBW, CI in pregnancy, caution in liver disease, diabetes, geriatric patients

Question 8

Rosuvastatin

Answer 8

Crestor

Cardiovascular

Cholesterol Lowering

Statin

Hyperlipidemia, Prevention of cardiovascular disease, familial hypercholesterolemia

myalgias, rhabdomyolysis, elevated LFTs, elevated blood glucose

warfarin

No BBW, CI in pregnancy, caution in liver disease, diabetes, geriatric patients

Question 9

Simvastatin

Answer 9

Zocor
Cardiovascular
Cholesterol Lowering
Statin
Hyperlipidemia, Prevention of cardiovascular disease, familial hypercholesterolemia
myalgias, rhabdomyolysis, elevated LFTs, elevated blood glucose
gemfibrozil, CCBs, macrolides
No BBW, CI in pregnancy, caution in liver disease, diabetes, geriatric patients

Question 10

Omega 3 Fatty Acids

RX and OTC

Answer 10

Lovaza
Vascepa
Cardiovascular
Supplement/Cholesterol Lowering
Dietary Supplement
Dietary Supplement; Hypertriglyceridemia
Eructaton; fishy aftertaste/burb; GI irritation
Antiplatelets; Warfarin
Hepatic effects; Lipid elevaton; Fish allergy; Prolonged bleeding time

Question 11

Which of the following medications is a statin?
A. Atorvastatin
B. Fenofibrate
C. Ezetimibe
D. Niacin

Answer 11

A. Atorvastatin

Question 12

Muscle pain due to a statin medication will present…
A. In one calf only
B. In both calve

Answer 12

B. In both calve
Could occur in only one calf, but
most likely CK will be elevated from
muscle breakdown universally, causing muscle pain in both calves. Unilateral calf pain may be a sign of overexertion

Question 13

Statins should be used cautiously in which patient population?
A. Pregnant	females
B. Cognitive	decline
C. Physically inactive
D. Heart failure

Answer 13

B. Cognitive decline

Question 14

Which of the following branded medications	 contains a cholesterol	absorption inhibitor?
A. Crestor®
B. Tricor®
C. Lipofen®
D. Zetia®

Answer 14

D. Zetia®

Question 15

Which of the following branded medications is a fibrate?

A. Lipofen®
B. Lipitor®
C. Mevacor®
D. Vytorin®

Answer 15

A. Lipofen®

Question 16

Niacin should be avoided in which disease state?
A. High blood pressure
B. Gout
C. Kidney disease

Answer 16

B. Gout

Question 17

Which cholesterol medication should be selected in	patients	with primarily elevated triglycerides?
A. Fenofibrate
B. Niacin
C. Atorvastatin
D. Ezetimibe

Answer 17

A. Fenofibrate

Question 18

Simvastatin	should not be	administered with which	of the	following medications?
A. Lisinopril
B. Ezetimibe
C. Fenofibrate
D. Hydrochlorothiazide

Answer 18

C. Fenofibrate

Question 19

Which supplement causes a	fishy taste or smell?
A. VitaminC
B. VitaminD
C. Ferrous Sulfate
D. Omega 3 Fatty Acids

Answer 19

D. Omega 3 Fatty Acids

Question 20

Patient counseling for statins

Answer 20

Patients should be educated about risk for muscle aches- stress this is usually bilateral in the calves

DO NOT use red yeast rice for cholesterol control especially while taking statins- contains lovastatin

Discuss the importance of contraception in women of child bearing age

Question 21

Clinical pearls for statins

Answer 21

Drug interactions and side are least likely with hydrophilic- pravastatin, rosuvastatin

Patients can try out statins when experiencing muscle pain

Statins target LDL cholesterol- first line therapy in dylipidemia

Question 22

Patient counseling for cholesterol absorbing inhibitors

Answer 22

Report any signs of vomiting, nausea, abnormal pain or change in appetite- gall stones

Take it with same time daily- consider with a meal

Question 23

Patient counseling for fibrates

Answer 23

Take 30mins before meals

Avoid alcohol

Question 24

Patient counseling for water soluble vitamins

Answer 24

Swollen tablets whole

Pretreat with Aspirin or ibuprofen

Flushing may be worsen by hot baths showers hot beverages and spicy foods

Question 25

Clinical pearls for water soluble vitamins

Answer 25

ER dosing is not equal to IR dosing

Question 26

Patient counseling for omega 3 fatty acids

Answer 26

Fishy burb can be minimized by freezing caplets

Review EPA AND DHA

Question 27

Hyperlipidemia

Answer 27

High cholesterol

Question 28

LDL

Answer 28

bad cholesterol

Question 29

HDL

Answer 29

Good cholesterol

Question 30

Dylipidemia

Answer 30

Abnormal cholesterol

Question 31

Myalgia

Answer 31

Muscle pain

Question 32

Rhabdomyolysis

Answer 32

Muscle breakdown

Question 33

Eructation

Answer 33

Burp