2-3. Dyslipidemia Drugs

Question 1

first line therapy for high cholesterol or TGs?

Answer 1

Diet

Question 2

what class of dyslipidemia drugs are metabolized by CYP450?

Answer 2

Statins

Question 3

3 contraindications for statins?

Answer 3

Pregnancy
Nursing mothers
Liver disease

Question 4

MOA of ezetimibe?

Answer 4

inhibits cholesterol absorption in GI

Question 5

function of Lipoprotein lipase?
locaiton?

Answer 5

degrades TGs, chylomicrons and VLDL.

on vascular endothelial surface

Question 6

3 MOA of fibrates?

receptor?

Answer 6

inc LPL (by inhibiting ApoC-III)
inc HDL
Dec TG (increase VLDL clearance)

Binds PPAR

Question 7

effect of thiazides on lipid levels?

beta-blockers?

oral contraceptives

Answer 7

elevate cholesterol and TGs

elevates TGs and decrease HDL

elevate TGs

Question 8

what dyslipidemia drug class are teratogenic?

Answer 8

Statins

Question 9

3 MOA of statins?

Answer 9

reversible competitive inhibition of HMG CoA reductase
Increase hepatic LDL receptors
increase HDL

Question 10

wt is elevated in Type III familial dysbetalipoproteinemia?

cause?

Answer 10

Chylomicrons and VLDL

defective ApoE

Question 11

2 drug classes to lower TGs?

Answer 11

Fibrates

Niacin

Question 12

wt is elevated in Type I familial hyperchylomicronemia?

2 cause?

tx?

Answer 12

chylomicrons, TG and cholesterol

deficient LPL or apolipoprotein C-II

diet. fibrates + nicotinic acid

Question 13

hw to calculate LDL?

Answer 13

obtaine Total cholesterol
TG
HDL

Question 14

wt is elevated in Type IV familial hypertriglyceridemia?

cause?

tx?

Answer 14

VLDL and TG

overproduction of VLDL

Fibrates

Question 15

MOA of alirocumab and evolocumab?

Answer 15

PCSK9 inhibitors. PCSK9 degrades hepatic LDL receptors

Question 16

2 statins that lower cholesterol and triglycerides?

2 ways they are different from other statins?

Answer 16

Atorvastatin
Rosuvastatin

longer t1/2
higher increase in LDL receptor

Question 17

wt is elevated in Type IIa familial hypercholesterolemia?
IIb hyperlipoproteinemia?

cause?

Answer 17

IIa = LDL, cholesterol
IIb = LDL, cholesterol and VLDL

defective/absent LDL receptors

Question 18

main source for plasma lipids in the fasting state?

Answer 18

liver

Question 19

wt lipids are most important for CV disease?

wt predisposes pts to acute pancreatitis?

Answer 19

cholesterol
TGs

severe hyperTGs = pancreatitis

Question 20

2 lifestyle causes of high TGs?

Answer 20

high carbs and alcohol

Question 21

2 AEs of fibrates?

Answer 21

Gall stones

myopathy

Question 22

function of APo-B-100?
3 locations?

Answer 22

binds LDL receptor

LDL, HDL, IDL

Question 23

2 dyslipidemia drugs that cause myopathy?

Answer 23

statins

Fibrates

Question 24

2 AEs of statins?

Answer 24

Elevate LFTs

inc. CPK

Question 25

wt esterfies cholesterol in periphery for packaging?
wt activates it?
location of activator?

Answer 25

LCAT
A-I
on HDL

Question 26

hw to tx familial hypercholesterolaemia in adolescence?

Answer 26

Statins

Question 27

main dietary determinants of plasma cholesterol?

why?

Answer 27

saturated and trans-unsaturated fatty acides

reduce LDL-receptor activity

Question 28

why are statins associated with myalgia?

Answer 28

they increase CPK

Question 29

first step when evaluating for lipid abnormalities?

Answer 29

consider the effect of other diseases and drugs

Question 30

2 AEs of resins?

Answer 30

GI

dec absorption of ADEK vitamins and drugs

Question 31

3 MOA of resins?

name some

Answer 31

bind bile acids in SI and inhibit reabsorption
Inc. hepatic LDL receptors
Inc. hepatic conversion of cholesterol to Bile acids

CHOLEStyramine, COLESevelam, COLEStipol