Prophylaxis of Atherosclerotic Cardiovascular Disease
 Flashcards

1
Q

Atherosclerotic Cardiovascular Disease
(ASCVD)

A

thicken of artery
angina 1st symptom
damage to vessels result in MI or stroke; related to increasing LDL

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2
Q

Cholesterol

A

component of all cell membranes and membranes of intracellular organelles; synthesis of the hormone, bile salts; from diet but mostly by LIVER (HMG-CoA reductase)

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3
Q

Lipoproteins

A

HDL
LDL
VLDL

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4
Q

HDL

A

high density
carry cholesterol
want high reduces the risk of ASCVD

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5
Q

LDL

A

mostly cholesterol
delivery of cholesterol
want low; a lot is a big risk for atherosclerosis

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6
Q

VLDL

A

triglycerides; deliver triglyceride; want low; if high risk of pancreatitis

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7
Q

Triglycerides

A

store unused calories and provide your body with energy;

eat more calories than you burn, particularly “easy” calories like carbohydrates and fats, you may have high triglycerides

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8
Q

ASCVD Risk Factors

A

Age, African American, HTN, smoking, low HDL, diabtets

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9
Q

Non-Pharmacologic Methods for Cholesterol Reduction
(Therapeutic Lifestyle Changes)-FIRST LINE TX

A

Diet (reduce sat fat, cholesterol, trans fat; increase fiber)

exercise
weight control
smoking reduction
do with drugs

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10
Q

Antihyperlipidemics

A
only if lifestyle changes didnt work; 
Bile Acid Sequestrants
Fibrates
Nicotinic Acid
HMG-CoA reductase inhibitors (Statins)
(LDL will go back if not taken meds)
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11
Q

LDL-Lowering Drugs - Statins

A

lovastatin
atorvastatin
pravastatin
simvastatin

Inhibit the enzyme HMG CoA reductase cholesterol synthesis

reduce LDL increase HDL

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12
Q

lovastatin
atorvastatin
pravastatin
simvastatin

A

so statins are most effective when taken in the evening (usually with dinner); improved clinical outcome

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13
Q

side effects of statins

A
monitor liver (hepatoxicity)
eye exams for cataracts
MUSCLE ACHES
watch for Rhabdo
GI
memory
diabetes
pregnancy category X
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14
Q

LDL-Lowering Drugs - Statins drug interactions

A

antibiotics, HIV meds, antifungals, and cardiac meds.

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15
Q

LDL-Lowering Drugs – Bile Acid Sequestrants

A

LDL binds with bile acids prevent absorption and promote excretion;
Cholestyramine
Colesevelam

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16
Q

Colesevelam - NEWER

A

does not impair vitamins; fewer drug interactions; can cause hypoglycemia; minimal GI symptoms

17
Q

Cholestyramine- OLDER

A

impair vitamin ADEK; may require supplements; space 1 hour before or 4 after; mix the powder with water juice soup applesauce (constipation)

18
Q

LDL-Lowering Drugs - Other

A

ezetimibe

blocks dietary cholesterol absorption and inhibits reabsorption in the small intestine

19
Q

ezetimibe

A

reduces LDL reduces triglycerides; slight increase HDLs; alone or with statin

20
Q

ezetimibe side effects

A

rhabdo
hepatitis pancreatitis
thrombocytopenia

21
Q

Triglyceride-Lowering Agents-Fibrates

A

increase risk of rhabdo with statins; 3rd line; reduce triglycerides, increase HDL no effect on LDLs

Gemfibrozil
fenofibrate

22
Q

Gemfibrozil

fenofibrate

A

GI, rash, gallstones, hepatotoxicity

if used with warfarin it increases anti coag effect monitor INR

23
Q

Antihyperlipidemic-Niacin

A

Reduces VLDL & LDL
Increases HDL

side effects: flush, warm, burning skin; decrease over time with aspirin