Lipid Lowering Drugs

Question 1

Target for total cholesterol?

Answer 1

4 mmol/L

Question 2

Target LDL levels?

Answer 2

2 mmol/L

or less than 1.8 for CVD patients

Question 3

Target triglyceride levels?

Answer 3

Below 2 mmol/L

Question 4

Target HDL levels?

Answer 4

More than 1 mmol/L

Question 5

Why does not fasting alter LDL levels in a blood test?

Answer 5

Due to the calculation used for LDL. Not fasting increases serum triglycerides which will make the LDL appear lower than it actually is

Question 6

Is LDL higher in the morning or evening

Answer 6

Evening

Question 7

How is mixed hyperlipidaemia classified?

Answer 7

Either predominately hypercholesterolaemia or hypertriglyceridaemia

Question 8

Longest acting statins?

Answer 8

Rosuvastatin and atorvastatin

Question 9

MOA of statins?

Answer 9

HMG CoA reductase inhibitors. Reduces the hepatic production of cholesterol, resulting in an increase of uptake of LDL plasma cholesterol. Reduces LDL levels

Question 10

Do statins reduce triglycerides?

Answer 10

Yes but not as much as cholesterol

Question 11

Most effective dose time for statins?

Answer 11

Evening. Due to daily variation

This is more important for the short acting statins not the long acting ones

Question 12

Rare ADR of statins?

Answer 12

Rhabdomyolysis

Question 13

Main enzymes monitored while on statins?

Answer 13

ALT and CK

Question 14

Which 2 statins are not metabolised by CYP enzymes?

Answer 14

Pravastatin and rosuvastatin

Question 15

Which drug class does cholestyramine belong to?

Answer 15

Resin

Question 16

MOA of fibrates?

Answer 16

Decrease the production and increase the clearance of VLDLs and triglycerides

Question 17

Which drug class is better for hypertriglyceridaemia than statins?

Answer 17

Fibrates

Question 18

Gemfibrozil is an example of which drug class?

Answer 18

Fibrates

Question 19

MOA of nicotinic acid?

Answer 19

Inhibits peripheral breakdown of fat which decreases the hepatic production of triglycerides and VLDL

Question 20

Compare LDL and VLDL

Answer 20

VLDL, like LDL, is bad cholesterol, however it also carries triglycerides

Question 21

Ezetimibe MOA?

Answer 21

Reduces the absorption of dietary and biliary cholesterol. Commonly combined with statins

Question 22

Fish oils are used to decrease..?

Answer 22

Triglycerides

Question 23

Explain the use of PCSK9 inhibitors

Answer 23

They prevent PCSK9 from degrading LDL receptors on hepatocytes. This increases LDL uptake and reduces plasma levels. Only need to take dose once every few weeks

Question 24

Name a PCSK9 inhibitor

Answer 24

Evolocumab or alirocumab

Question 25

Best drug class for hypercholesterolaemia?

Answer 25

Statin

Question 26

Second line treatment for high cholesterol?

Answer 26

Combination therapy with statin (e.g. ezetimibe, fibrates or nicotinic acid)