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Cardio Exam 2 > Anti-Lipid Drugs > Flashcards

Anti-Lipid Drugs Flashcards

1
Q

role of HMG CoA reductase inhibitors

A
  • block the synthesis of cholesterol - increase the uptake of LDL
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2
Q

pharmacokinetics issues with BABAs

A
  • daily doses are in grams (huge) - alternate to statins during pregnancy - can be used with statins
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3
Q

HMG CoA reductase inhibitors role with nitric oxide

A
  • increase endothelial nitric oxide production - vasorelaxation
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4
Q

common, but not serious toxicities with niacin

A
  • flushing - pruritus
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5
Q

MOA of fibric acid derivatives

A
  • increase LDL receptor expression - activates LPL - increase free fatty acid metabolism
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6
Q

what is the significance of some statins being taken at night?

A
  • they have a short half life - want to reach peak effect during cholesterol synthesis peak
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7
Q

gemfibrozil used for

A
  • anti-cholesterol
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8
Q

HMG CoA reductase inhibitors and platelets

A
  • reduce platelet activation - reduce risk of venous thromboembolism
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9
Q

role of NPC1

A
  • cholesterol transport protein
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10
Q

MOA of niacin

A
  • inhibits synthesis of triglycerides in the liver
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11
Q

when does liver cholesterol synthesis peak?

A
  • between midnight at 2 AM
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12
Q

HMG CoA reductase inhibitors and plaques

A
  • stabilize arterial plaques - reduce risk of thrombus
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13
Q

cholesterol absorption inhibitors drug to know

A
  • Ezetimibe
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14
Q

role of PCSK9

A
  • induces LDL-receptor degradation - LDL-receptor bound to PCSK9 is digested in lysosome
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15
Q

serious, not common toxicities of niacin

A
  • hepatotoxicity - insulin resistance
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16
Q

proteins in LDL

A
  • ApoB
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17
Q

HMG CoA reductase inhibitors drug examples

A
  • Atorvastatin - Rosuvastatin - Simvastatin - Pravastatin - Lovastatin
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18
Q

what happens if you inhibits absorption of cholesterol with ezetimibe what happens if you inhibit cholesterol synthesis with statins what do you do?

A
  • you increase cholesterol synthesis so maybe more can be absorbed - you increase cholesterol absorption COMBINE THEM BOTH
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19
Q

BABA example

A
  • colestipol
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20
Q

role of LPL

A
  • breaks down triglycerides
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21
Q

MOA of toxicities of fibric acid derivatives with oral anticoagulants

A
  • kick warfarin off albumin - free serum warfarin - increased bleeding risk
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22
Q

result of class 3 niacin

A
  • decrease LDL - decrease triglycerides - increase HDL
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23
Q

results of class 2 BABAs

A
  • decrease LDL a bit
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24
Q

important drugs that inhibit CYP3A4

A
  • gemfibrozil - amlodipine - warfarin
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25
Q

which statins are the most potent?

A
  • atorvastatin - Rosuvastatin
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26
Q

warfarin used for

A
  • anti-coagulant
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27
Q

HDL composed of

A
  • more protein - less cholesterol/triglycerides
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28
Q

PCSK9 drug

A
  • Alirocumab
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29
Q

MOA of toxicities of fibric acid derivatives with statins

A
  • inhibit statin absorption in liver - increased serum statin leads to myopathy
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30
Q

MOA of bile acid binding agents (BABA)

A
  • increase elimination of bile acids - draw more cholesterol out of the liver - liver expresses more LDL receptors
31
Q

statin patients highly susceptible to hepatotoxicity

A
  • patients with underlying liver disease - or chronic alcohol abuse
32
Q

how are cholesterol and triglycerides transported in the plasma?

A
  • in complexes with proteins
33
Q

proteins in HDL

A
  • ApoA/C/E
34
Q

local toxicities with BABAs

A
  • GI toxicities (dyspepsia) - flatulence/bloating - diarrhea/constipation
35
Q

class 2 drug anti-hyperlipidemia drugs

A
  • bile acid binding agents
36
Q

result of class 1 statins

A
  • decrease LDL - decrease triglycerides
37
Q

statin myopathy can turn into

A
  • rhabdomyolysis
38
Q

HMG CoA reductase inhibitors reduce risk of venous thromboembolism by what %

A
  • 43% reduction
39
Q

importance of niacin use in diabetics

A
  • use cautiously in diabetics
40
Q

what do you give to pregnant women instead of statins

A
  • Bile acid binding agents
41
Q

class 6 anti-hyperlipidemia drugs

A
  • cholesterol absorption stimulators - PCSK9 inhibitors
42
Q

importance of taking other drugs with BABAs

A
  • take other drugs 1 hour before or 3 hours after BABAs
43
Q

Class 1 of anti-hyperlipidemia drugs

A
  • HMG CoA reductase inhibitors
44
Q

drug interaction MOA with BABAs

A
  • reduce the absorption of numerous drugs from the gastrointestinal tract
45
Q

HMG CoA reductase inhibitors and atherogenesis

A
  • reduce inflammation in atherogenesis
46
Q

class 5 anti-hyperlipidemia drugs

A
  • cholesterol absorption inhibitors
47
Q

toxicities with fibric acid derivates

A
  • myopathy when used in combination with high dose statins - bleeding when used with anti-coagulants
48
Q

importance of PCSK9 inhibitors

A
  • antibodies that must be injected intramuscularly biweekly
49
Q

class 4 anti-hyperlipidemia drugs

A
  • fibric acid derivatives
50
Q

LDL composed of

A
  • less protein - more cholesterol/triglycerides
51
Q

what statins should you take in the evening?

A
  • lovastatin - simvastatin - fluvastatin
52
Q

amlodipine used for

A
  • anti-hypertension
53
Q

which are the most widely prescribed anti-hyperlipidemia drugs

A
  • class 1 statins
54
Q

result of class 4 fabric acid derivatives

A
  • decrease triglycerides
55
Q

toxicities of statins

A
  • birth defects - hepatotoxicity - myopathy - drug interactions
56
Q

result of class 5 Ezetimibe

A
  • decrease LDL
57
Q

composition/function of BABA

A
  • polymeric resins - bind and sequester bile salts
58
Q

bile salts are derivatives of

A
  • cholesterol
59
Q

another name for HMG CoA reductase inhibitors

A
  • statins
60
Q

fibric acid derivates drug

A
  • Gemfibrozil - Fenofibrate
61
Q

MOA of PCSK9 inhibitors

A
  • block LDL-receptor degradation - allows more LDL to be taken into cell in liver
62
Q

what is an important cytochrome of statin action that inhibitors also act on

A
  • CYP3A4
63
Q

which statins does amlodipine interact with

A
  • simvastatin - lovastatin - atorvastatin
64
Q

statin hepatotoxicity occurs in what percentage of patients?

A
  • 1-3%
65
Q

importance of simvastatin dose with amlodipine

A
  • should not exceed 20 mg/day with amlodipine
66
Q

MOA of amlodipine drug interaction

A
  • slows metabolism of statins - increases risk of muscle damage/rhabdomyolysis
67
Q

statin myopathy risk increases with

A
  • dose - age - hepatic or renal dysfunction - interaction with other drugs
68
Q

Ezetimibe MOA

A
  • NPC1 cholesterol receptor inhibitor - blocks absorption of cholesterol from intestines - stimulates LDL-receptor expression
69
Q

systematic toxicities with BABAs

A
  • not absorbed systematically, so no systemic toxicities
70
Q

statins patients highly susceptible to hepatotoxicity should have what tests run before they take the drug?

A
  • baseline and follow up serum aminotransferase activity
71
Q

another name for niacin

A
  • vitamin B3
72
Q

result of class 6 PCSK9 inhibitors

A
  • decrease LDL a lot
73
Q

class 3 anti-hyperlipidemia drugs

A
  • niacin
74
Q

do daily multivitamins provide a lot of niacin

A
  • no

Cardio Exam 2 (29 decks)

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