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CPT > Hyperlipidaemia > Flashcards

Hyperlipidaemia Flashcards

1
Q

What are some examples of statins?

A

Atorvastatin

Simvastatin

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2
Q

What are the main actions of statins?

A

Competitive inhibition of HMG-CoA reductase
Up-regulation of hepatic LDL receptors
Increased clearance of circulating LDL

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3
Q

What are some additional benefits of statin therapy?

A 
Improved vascular endothelial function 
Stabilisation of atherosclerotic plaque 
Improved haemostasis 
Anti-inflammatory 
Antioxidant
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4
Q

What enzymes metabolise statins?

A

CYP 3A4

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5
Q

What are some ADRs of statins?

A 
Transient serum transaminase elevation 
Myalgia - dose related, probs due to interactions w/ other cholesterol lowering agents 
Can rarely cause rhabdomyolysis 
GI disturbances 
Nausea 
Headache
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6
Q

What should be avoided when taking statins?

A

Grapefruits - CYP 3A4 inducer

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7
Q

What is an example of a fibrate?

A

Fenofibrate

Ciprofibrate

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8
Q

How do fibrates exert their effects?

A

Activation of nuclear transcription factor, PPARα

This regulates expression of genes that control lipoprotein metabolism => increase production of lipoprotein lipase

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9
Q

What are the effects of fibrates?

A

Enhance clearance of triglycerides
Increase fatty acid uptake by the liver
Increases LDL affinity for receptor

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10
Q

What are indications for prescribing fibrates?

A

Adjunctive therapy to diet

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11
Q

What are some side effects of taking fibrates?

A 
GI upset 
Cholesthiasis 
Myositis
Abnormal LFTs 
Warfarin potentiation
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12
Q

What is another name for nicotinic acid?

A

Niacin - vitamin B3

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13
Q

How does niacin exert its effects?

A

Anti-lipolytic => reduced fatty acid supply => decreased triglyceride synthesis

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14
Q

What are some ADRs of niacin?

A 
Flushing 
Headache 
Itching 
Hepatotoxicity 
GI disturbance
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15
Q

What is an example of cholesterol absorption inhibitors?

A

Ezetimibe

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16
Q

How do cholesterol absorption inhibitors exert their effects?

A

Acts at brush border of small intestine mucosa
Reduces absorption of cholesterol from gut by ~50%
Hepatic LDL receptor expression increases

17
Q

What are some ADRs of cholesterol absorption inhibitors?

A

Headache
Abdo pain
Diarrhoea

Generally well tolerated

18
Q

What are examples of monoclonal antibodies used in treatment for hypercholesterolaemia?

A

Alirocumanb

Evolocumab

19
Q

How can monoclonal antibodies be used to reduce LDL cholesterol?

A

Inhibit PCSK9

This protein normally brings to internalised LDL-R which directs for degradation

20
Q

What are some non-POM options for hypercholesterolaemia?

A 
Plant sterols 
Fish oils 
Fibre 
Vit C/E
Alcohol
21
Q

How do plant sterols act to reduce blood cholesterol?

A

Structurally similar to cholesterol therefore compete for absorption
Works with statins, but not ezetimibe

Naturally occurring in grains, legumes etc

CPT (21 decks)

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