Flashcards in Cholesterol Deck (21):
What do Bile Acid Sequestrants do?
- Reduce cholesterol by binding bile acids in gut.
- Increase fecal loss of bile salt bound LDL cholesterol
Are there drug interactions with bile acid sequestrants?
They bind drugs in the GI tract
Preparations of Bile acid sequestrants
1. Cholestyramine resin
What does Nicotinic acid do?
- Decreases liver triacylglycerol synthesis necessary for VLDL production
- Decreased VLDLs decreases plasma LDLs
- Can reverse some endothelial cell dysfunction leading to thrombosis caused by high cholesterol and atherosclerosis
Which drug is the least expensive out of all the drugs stated in connection with high cholesterol
Nicotinic acid (niacin)
Side effect of Nicotinic acid
What do Fibric Acids do?
- Lower plasma triglycerides
- Increases HDLs
- Inhibit cholesterol synthesis in liver
Name the preparations for fibric acids
*(look for fiber)
What are the leading cholesterol-lowering medications?
HMG CoA Reductase Inhibitors
How is the HMG CoA Reductase Inhibitor associated with cholesterol?
It is the rate limiting step in the synthesis of cholesterol
Drugs lower cholesterol by what 2 methods?
1. Decreases synthesis of cholesterol in liver
2. Increases LDL breakdown (decreases existing bad cholesterol)
T or F, New evidence shows that statins have anti-inflammatory activity and may also increase HDLs in some individuals
In what clinical scenario is a patient not able to take HMG CoA reducatse Inhibitors?
Cannot take if liver disease
What are the side effects of statin drugs?
1. Drugs may alter liver function because that is their target
2. Myalgias (disintegration of muscle tissue)
Avoid use of statin drugs in conjunction with what other drugs?
- Avoid use of macrolide antibiotics (erythromycin) and systemic (azole) antifungal medifications in statin users. Promotes rhabomlis
- Red flag drugs!!!
What is ezetimibe?
- A combination drug taken with statins
- Decresases intestinal cholesterol absorption
Statin (simvastatin) + ezetimibe (Zetia) = ?
Statin (atorvastatin) + ezetimibe (Zetia) = ?
ACC/AHA guidelines for statin therapy
1. Patients without CVD who are 40 to 75 and have a 7.5% or higher risk for having a heart attack or stroke within 10 years.
2. History of a CV event
3. 21 years and older who have a very high level of bad cholesterol
4. With type 1 or type 2 diabetes who are 40 to 75 years old
It is no longer a guideline to prescribe what if patients don't reach targets with statins alone?
- Don't prescribe additional cholesterol-lowering drugs such as fibrates and niacin
- These drugs have not been shown to reduce heart attack or stroke risk