Anti-hyperlipidemic

Question 1

What is the leading cause of death in the United States

Answer 1

coronary artery disease

Question 2

Who benefits most from statin use

Answer 2

Males who have had a heart attack or stroke

Question 3

Besides lowering cholesterol, what notable effect do statins have

Answer 3

They lower inflammation, which may promote greater response to NO, epi, nor, and such

Question 4

What form of niacin supplementation is effective at lowering blood lipids

Answer 4

nicotinic acid, NOT niacinamide. inositol hexaniacinate is the best form, with the fewest side effects and no liver damage.

Question 5

What are notable side effects of niacin supplementation

Answer 5

GI effects, sore muscles, flushing, and skin itch. Take slow release form to decrease side effects

Question 6

How can one reduce the niacin flush

Answer 6

take ibuprofen or aspirin before the niacin

Question 7

What are the indications for niacin

Answer 7

Elevated total cholesterol, elevated VLDL, LDL, TG and low HDL levels

Question 8

Who is not a candidate for niacin therapy

Answer 8

Contraindicated in patients with poorly controlled DM, active liver disease or active peptic ulcer disease. Must monitor LFTs and glucose levels

Question 9

What are fibric acid derivatives most useful for

Answer 9

lowering high triglycerides

Question 10

What are common side effects for fibric acid derivatives

Answer 10

liver damage, gall stone formation, nausea, diarrhea, GI upset, rhabdomyolysis and myalgias

Question 11

what is the major precursor for all steroid hormones which include estrogens, cortisol and aldosterone?

Answer 11

Cholesterol

Question 12

what drug class is Gemfibrozol

Answer 12

anti-hyperlipidemic, fibric acid derivative

Question 13

For whom is gemfibrozol use contraindicated

Answer 13

Those with gallbladder disease or liver disease

Question 14

What should always be given with a statin

Answer 14

supplemental coQ10 should be given since statins block HMG CoA reductase, which makes ubinquinone

Question 15

What should always be given with a statin

Answer 15

supplemental coQ10 should be given since statins block the production HMG CoA reductase, which makes ubinquinone

Question 16

What are contraindications to statin use

Answer 16

heavy alcohol use, liver disease, unexplained elevated LFT, pregnancy, lactation

Question 17

what drug class is atorvostatin (lipitor)

Answer 17

HMG-CoA reductase inhibitor

Question 18

what are the indications of atorvostatin (lipitor)

Answer 18

Elevated total cholesterol, elevated LDL, low HDL levels. Indicated for symptomatic and non-symptomatic coronary artery disease

Question 19

what labs should be run for baseline in statin use

Answer 19

LFTs (6 and 12 week followup), and CPK is also helpful

Question 20

What are some off-label uses for bile acid sequestrants

Answer 20

liver failure patients to help with severe pruritus and increasing ammonia levels. Has been used in pseudomembranous colitis too because it binds the toxins

Question 21

what are some side-effects of Cholestyramine (Questran)

Answer 21

Bloating, constipation, may interfere with the absorption of fat soluble vitamins and folic acid.

Question 22

What drug class is cholestyramine (questran)

Answer 22

Bile acid sequestrate

Question 23

What drug class is Ezetimibe (Zetia)

Answer 23

Cholesterol absorption inhibitor

Question 24

what is the MOA of ezetimibe (zetia)

Answer 24

Inhibits intestinal absorption of cholesterol at the brush border

Question 25

What drug class is lovaza

Answer 25

it is prescription esterified fish oil