Cardio - Pharm (Part 2: Lipid-lowering agents) Flashcards Preview

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Flashcards in Cardio - Pharm (Part 2: Lipid-lowering agents) Deck (22):
1

What is the common suffix for HMG-CoA reductase inhibitors? What are 5 examples of such drugs?

STATINS (-vastatin) = (1) Lovastatin, (2) pravastatin, (3) simvastatin, (4) atorvastatin, (5) rosuvastatin

2

What kind of cholesterol is LDL considered to be? What kind of cholesterol is HDL considered to be?

"Bad cholesterol"; "Good cholesterol"

3

What is the mechanism of action of HMG-CoA reductase inhibitors?

Inhibit conversion of HMG-CoA to mevalonate, a cholesterol precursor

4

What is the effect of HMG-CoA reductase inhibitors on the following: (1) LDL (2) HDL (3) Triglycerides?

(1) Very significant decrease (3 down arrows); (2) Increase (1 arrow up); (3) Decrease (1 arrow down)

5

What are 2 side effects/problems associated with HMG-CoA reductase inhibitors? What is important to associate with each of these side effects/problems?

(1) Hepatotoxicity (Increased LFTs) (2) Rhabdomyolysis (especially when used with fibrates and niacin)

6

What is another name for niacin? What is this drug's mechanism of action?

Vitamin B3 (water soluble vitamin); (1) Inhibits lipolysis in adipose tissue, (2) Reduces hepatic VLDL synthesis

7

What is the effect of Niacin (vitamin B3) on the following: (1) LDL (2) HDL (3) Triglycerides?

(1) Significant decrease (2 arrows down) (2) Significant increase (2 arrows up) (3) Decrease (1 arrow down)

8

What are 3 side effects/problems associated with niacin (vitamin B3)? What is important to remember about each of these side effects/problems?

(1) Red, flushed face (decreased by aspirin) (2) Hyperglycemia (causes acanthosis nigricans) (3) Hyperuricemia (exacerbates gout)

9

What are 3 examples of bile acid resins?

Cholestyramine, colestipol, colesevelam

10

What is the mechanism of action of bile acid resins?

Prevent intestinal reabsorption of bile acid = Liver must use cholesterol to make more

11

What are general kinds/groups of lipid-lowering agents? Give examples belonging to each class, where applicable.

(1) HMG-CoA reductase inhibitors - lovastatin, pravastatin, simvastatin, atorvastatin, rosuvastatin (2) Niacin (vitamin B3) (3) Bile acid resins - cholestyramine, colestipol, colesevelam (4) Cholesterol absorption blockers - ezetimibe (5) Fibrates - gemfibrozil, clofibrate, benzofibrate, fenofibrate

12

What is the effect of Bile acid resins on the following: (1) LDL (2) HDL (3) Triglycerides?

(1) Significant decrease (2 down arrows) (2) Slightly increase (3) Slightly increase

13

What are 2 common side effects/problems associated with bile acid resins?

(1) Patients hate it - tastes bad and causes GI discomfort (2) Decreased absorption of fat-soluble vitamins

14

What is the prime example of cholesterol absorption blockers?

Ezetimibe

15

What is the mechanism of action of cholesterol absorption blockers (ezetimibe)?

Prevent cholesterol absorption at small intestine brush border

16

What is the effect of Cholesterol absorption blockers (ezetimibe) on the following: (1) LDL (2) HDL (3) Triglycerides?

(1) Significant decrease (2 down arrows) (2) No effect (3) No effect

17

What are 2 side effects/problems associated with cholesterol absorption blockers (ezetimibe)?

(1) Rare increased LFTs (2) Diarrhea

18

What are 4 examples of Fibrates?

Gemfibrozil, clofibrate, bezafibrate, fenofibrate

19

What is the mechanism of action of fibrates?

Upregulate LPL --> Increased TG clearance; Activates PPAR-alpha to induce HDL synthesis

20

What is the effect of Fibrates on the following: (1) LDL (2) HDL (3) Triglycerides?

(1) Decreased (1 down arrow) (2) Increased (1 up arrow) (3) Very significant decrease (3 down arrows)

21

What are 3 side effects/problems associated with fibrates? What is important to remember about each of these side effects/problems?

(1) Myositis (increased risk with concurrent statins) (2) Hepatotoxicity (increased LFTs) (3) Cholesterol gallstones (esp. with concurrent bile acid resins)

22

Draw a diagram depicting the mechanisms of action of the different kinds of lipid-lowering agents.

See diagram on p. 281 in First Aid (bottom of page)