Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Pharmacology 2 > Anti-lipids > Flashcards

Anti-lipids Flashcards

(48 cards)

Start Studying
1
Q

macromolecular complexes in the blood that transport lipids

A

lipoproteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

proteins on surface of lipoprtoeins

A

apolipoproteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

enzyme that catalyzes rate-liming step in cholesterol

A

HMG-CoA reducttase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

enzyme found on surface of endothelial cells that release free fatty acids from triglycerides

A

lipoprotein lipase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what transport cholesterol and TGs from GI tract to body

A

chylomicrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TG-rich lipoproteins, precursor to LDL

A

VLDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can cause high cholesterol genetically?

A
  • familial hypercholesterolemia
  • familial hypertriglyceridemia
  • familial combined hyperlipidemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are contributing conditions for HLD

A

DM, alcoholism, obesity, CKD, glucocorticoids, OCPs, cyclosporine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

FLP

A

fasting lipid profile
- total cholesterol
- LDL
- HDL
- TGs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When do you start monitoring lipids?

A

20+ every 4-6 years, annually for higher risk patients
frequency based on family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Friedwald equation to

A

calculate LDL

LDL = TC - (HDL+(tris/5))
not accurate when tris>400

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Target lipid levels

A

LDL: <100
HDL >60
TGS <150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Target lifestyle

A

reduce saturated fats, increase omega-3s
at least 150min/week of exercise
weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

most common and effective drug class to decrease LDL, reduce inflammation, stabilize plaques

A

statins (HMG-CoA reductase inhibitors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What medications inhibit cholesterol synthesis + bind circulating LDL, stabilize plaques, inhibit thrombus, anti-inflammatory?

A

statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are ADRs of statins?

A

headache, arthralgia, MYALGIA, fatigue, flu-llike symptoms, myopathy and rhabdomyolysis
hepatotoxicity (monitor LFTs - if high, then severe hepatotoxicity)
signs of damage/labs persist = jaundice, light stools, dark urine, hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What combo with statins are not good?

A

macrolides, cyclosporine, azole antifungals, HIV protease inhibitors, verapamil, gemfibrozil, niacin, amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should you monitor with statins?

A

Cr and CK - check baseline + with symptoms

D/C drug if CK>19 x ULN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you treat statin myopathy?

A

CoQ-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are DDIs with statins?

Study These Flashcards
A

grapefruit with atorvastatin, simvastatin, lovastatin (3A4)
rosuvastatin 2C9
pravastatin = no CYP450

21
Q

What are CIs of statins?

Study These Flashcards
A
  • pregnancy (no in any child-bearing age)
  • liver disease
  • severe illness, trauma, surgery
22
Q

What med:
- lowers LDL + TGs, increases HDL
- decreased hepatic production of VLDL -> less LDL + trigs

Study These Flashcards
A

niacin (vitamin B3): nicotinic acid

23
Q

What are ADRs of niacin

Study These Flashcards
A

lots-
flushing (can take aspirin beforehand and avoid alcohol, spicy foods, hot showers/baths after taking)
hyperglycemia
hyperuricemia
GI upset
hepatotoxicity

24
Q

What are CIs of niacin?

Study These Flashcards
A

active or chronic liver disease, severe gout, caution in DM + PUD

25
How do you monitor niacin?
- LFTs baseline, q2-3 months for the first year, then periodically LFTs >/3xUNL = discontinue - glucose + uric acid levels baseline, 6-8 weeks, yearly, adverse effects
26
What is a cholesterol absorption inhibitor that lowers absorption in intestine>
ezetimibe (zetia)
27
Should you add ezetimibe to statins?
yes
28
Consider ____ if maximum statin dose with <50% LDL goal or LDL >100
ezetimibe
29
What are ADRs of zetia?
monotherapy = URI, diarrhea, arthralgias, sinusitis w/ statin = nasopharyngitis, myalgias, everything else
30
What are CIs of zetia?
avoid: cyclosporine, fibrates (increase) separate administration: bile acid sequestrants (decrease)
31
What do you monitor with zetia?
LFTs, CK, adverse events
32
What med reduces LDL but can cause GI side effects?
bile acid sequestrants - cholesytramine (questran) - colesevelem (welchol) - colestipol (colestid)
33
Binds bile acids in intestine + impedes reabsorption decrease LDL by 15-30% ** triglycerides may increase **
bile acid sequestrants
34
When <50% reduction in LDL on max statin or LDL > 70 zetia intolerant and triglycerides <300
add bile acid sequestrants
35
What are ADRs of bile acid sequestrants?
GI upset, N/V, bloating, constipation, abdominal pain
36
bile acid sequestrants have _____ DDIs
manyyyy - decreases absorption of other drugs - should be taken 4 hours before or after other drugs
37
activates lipoprotein lipase which leads to reduction in triglycerides, inducing synthesis of HDL
fibrates
38
What to use with hypertriglyceridemia >500
fibrates gemfibrozil (lopid), fenofibrate (tricor)
39
What are ADRs of fibrates?
GI upset, gallstones, constipation, myalgia, increase in LFTs
40
What are CIs of fibrates?
- renal impairment (CrCL <30) - hepatic impariment - use caution w/ Hx of gallbladder disease - monitor: LFTs at baseline, 3 months after, annually
41
What are DDIs of fibrates?
increased risk of rhabdomyolysis especially gemfibrozil (less with fenofibrate) warfarin = increases bleeding risk sulfonylureas = increase effect, MONITOR BS
42
What are PCSK9 inhibitors
praluent (alirocumab) and repatha (evolocumab) - SQ q2-4 weeks
43
Meds that inhibit PCSK9 from degrading LDL receptors
PCSK9 inhibitors
44
What can you add with patient <50% LDL reduction on max statin and LDL >70 and familial hypercholesteremia?
PCSK9 inhibitors up to 60% reduction
45
What are ADRs of PCSK9 inhibitors?
nasopharyngitis, injection site reactions, back pain - expensive, SQ injection, burdensome
46
Who should be treated?
1) ASCVD 2) LDL >/190 3) 40-75 w/ DM 4) LDL 70-189 w/ 10 year risk >7.5% 5) assess other risk factors
47
Lifestyle changes for
primary first line intervention
48
Statins are first line for
secondary prevention of CAD

Clinical Pharmacology 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions