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2 Cardiovascular > Cholesterol > Flashcards

Flashcards in Cholesterol Deck (24)
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1
Q

Three risk conditions that require primary CV prevention

A

CKD (eGFR

2
Q

10 year cadiovascular risk of over ….% should have primary prevention

A

10% (QRISK 2)

3
Q

CV risk tool don’t take into account ………. which may also contribute to risk (5)

A
  • serious mental disorder
  • autoimmune disorder (lupus)
  • antiretroviral treatment
  • meds increasing cholesterol
  • tirglyceride concentration >4.5mmol/L

(also those with controlled BP and those who have stopped smoking)

4
Q

Three med classes that can increase cholesterol

A

antipsychotics
corticosteroids
immunosupressants

5
Q

before starting statin treatment causes of hyperlipidaemia should be address such as (4)

A

diabetes
hepatic disease
nephrotic syndrome
hypothyroidism

6
Q

what is the effect of hypothroidism on lipids

A

should be corrected first ans lipid dysregulation may then correct itself.
Also - untreated increases risk of myosistis with lipid regulating drugs

7
Q

Statins that are high intensity (3)

A

Atrovastatin 20mg +
Rosuvastatin 10mg +
Simvstatin 80mg +

8
Q

when should a statin be considered in T1DM?

A

40years+
had diabetes for over 10 years
established nephopathy

9
Q

What are the NICE targets of statin therapy

A

total chol reduction of over 40%

non-HDL

10
Q

what are 2, 3, 4 lines after statins

A

ezetimibe
fenofibrate
nicotinic acid

11
Q

Does omega three fatty acid reduce cholesterol

A

no evidence of this

12
Q

What is the definition of a high intensity statin

A

one that produces a reduction in cholesterol greater that simv 40mg

13
Q

Coucelling for cholestyramine

A

Take sachet with 150ml of fluid

Take other meds at least 1 hour before or 4-6 hours after to reduce possible interferance with absorbtion

14
Q

What is the class of cholestyramine

A

bile acid sequestrant

15
Q

which patients are particularly at risk of statins muscle effects

A

muscle disorders
high alcohol intake
renal impairment
hypothyroidism

16
Q

when should statin be discontinued due to muscle pain

A

if creatanine is 5x the upper limit of normal

if pain is severe

17
Q

what should be suspected if a statin patient presents with dyspnoea, cough, weightloss

A

interstitial lung disease

18
Q

should statin be discontinued if they cause and increase in HbA1c

A

no - usually the benifits outweigh the risks

19
Q

at what level or LFT derangement should we definately not be using statins

A

discontinue if serum transaminases are 3x upper limit of normal

20
Q

3 monitoring tests for statins

A

HbA1c (may develop diabetes esp those at risk)
LFTs
CrCl

21
Q

drugs that interact with statins

A
fibrates
nicotinic acid
fusidic acid
and drugs that alter plasma statin levels:
imidazole and tiriazole antifungals
macrolides
22
Q

what statin can be sold OTC

A

simv 10

23
Q

max doses of simvastatin with other drugs stated in the BNF

A

10mg with bezafibrate
20mg with amiodarone, verapamil, diltiazem, amlodipine, ranolazine
40mg with lomitapide

24
Q

which statin interacts with clopidogrel?

what is the max dose

A

maximum dose of rousovastatin with clopidogrel

20mg