Pharmacology - Chapter 49 - Prophylaxis of Coronary Artery Disease - Drugs used to Lower Cholesterol Levels

Question 1

CAD - starts with….then what?

Answer 1

development of a fatty streak in arterial wall, followed by deposition of fibrous plaque. As plaque grows it begins to occlude artery, blocks blood flow, and causes angina. It may lead to thrombi leading to MI!!!!

Question 2

Risk of CAD directly related to levels of ___ cholesterol in blood.

Answer 2

LDL

Question 3

Cholesterol - component of all ___ membranes.

Answer 3

Cell.

Question 4

What are some of the things that cholesterol does?

Answer 4

Forms cell membranes, synthesizes hormones (like sex hormones) and others.

Question 5

Cholesterol comes from…

Answer 5

liver cells.

Question 6

What catalyzes the synthesis of cholesterol?

Answer 6

Hydroxymethylgutaryl Coenzyme A (HMG CoA)

Question 7

Give cholesterol lowering drugs in the morning. T/F?

Answer 7

FALSE - give them at night!

Question 8

What are plasma lipoproteins?

Answer 8

Carriers for transporting lipids cholesterol and triglycerides in the blood.

Question 9

What do apolipoproteins?

Answer 9

They serve as recognition sites for cell surface receptors.

Question 10

1, A-2 - deliver cholesterol to ____.

b-100 - deliver cholesterol to ____.

Answer 10

Non-hepatic/hepatic.

Question 11

What are VLDL’s?

Answer 11

Very Low Density - Triglycerides.

Question 12

LDL’s - what are they?

Answer 12

Bad cholesterol.

Question 13

HDL - what are they?

Answer 13

High density - contribute to protection against CAD.

Question 14

LDL - initiates and fuels development of…

Answer 14

Atherosclerosis.

Question 15

Total Cholesterol Levels - should be…

Answer 15

<150 mg/dl

Question 16

HDL Cholesterol - levels should be…..

Answer 16

> 40 mg/dl.

Question 17

LDL - level should be……

Answer 17

<100 mg/dl.

Question 18

Diet modification is not important for lowering cholesterol. T/F?

Answer 18

FALSE - it is very important!

Question 19

What are the lipid lowering drugs? (5)

Answer 19

HMG CoA reductase inhibitors, Bile acid-binding resins, nicotinic acid, fibric acid derivatives (fibrates), estrogen.

Question 20

What is an HMG CoA drug?

Answer 20

Lovastatin (Mevacor)

Question 21

what does lovastatin do?

Answer 21

Lowers LDL (increasing LDL receptors in the hepatocytes), lowers VLDL, improves HDL.

Question 22

What are some adverse effects of Lovastatin?

Answer 22

Headache, rash, and hepatotoxicity.

Question 23

What is a Bile Acid-Binding Resin?

Answer 23

Cholestyramine (Questran.)

Question 24

What does cholestyramine (questran) do?

Answer 24

It increases LDL receptors in the liver. It accelerates excretion/prevents absorption of bile acid.

Question 25

What are some adverse effects of Cholestyramine (Questran) ?

Answer 25

Constipation, decreased absorption of fat soluble vitamins.

Question 26

Nicotinic Acid - what does it do?

Answer 26

Decreases production of VLDL’s….

Question 27

What are some adverse effects of Nicotinic acid?

Answer 27

Skin (flushing, itching), nausea, vomiting, gastric upset, hepatotoxicity, hyperglycemia.

Question 28

Fibric Acid - what is the drug?

Answer 28

Gemfibrozil (Lopid)

Question 29

What does gemfibrozil (lopid) do?

Answer 29

It lowers high triglyceride levels.

Question 30

What are some adverse effects of gemfibrozil (lopid) ?

Answer 30

Rashes, gastrointestinal problems, gallstones, hepatoxicity.

Question 31

Estrogen - in postmenopausal women, estrogen therapy reduces LDL cholesterol by ___ to ___ %, increases HDL cholesterol by __ to __ %.

Answer 31

15-25%/10-15%.