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Flashcards in Cholesterol Deck (24):
1

Three risk conditions that require primary CV prevention

CKD (eGFR

2

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

10% (QRISK 2)

3

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

- 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

Three med classes that can increase cholesterol

antipsychotics
corticosteroids
immunosupressants

5

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

diabetes
hepatic disease
nephrotic syndrome
hypothyroidism

6

what is the effect of hypothroidism on lipids

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

7

Statins that are high intensity (3)

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

8

when should a statin be considered in T1DM?

40years+
had diabetes for over 10 years
established nephopathy

9

What are the NICE targets of statin therapy

total chol reduction of over 40%

non-HDL

10

what are 2, 3, 4 lines after statins

ezetimibe
fenofibrate
nicotinic acid

11

Does omega three fatty acid reduce cholesterol

no evidence of this

12

What is the definition of a high intensity statin

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

13

Coucelling for cholestyramine

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

What is the class of cholestyramine

bile acid sequestrant

15

which patients are particularly at risk of statins muscle effects

muscle disorders
high alcohol intake
renal impairment
hypothyroidism

16

when should statin be discontinued due to muscle pain

if creatanine is 5x the upper limit of normal
if pain is severe

17

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

interstitial lung disease

18

should statin be discontinued if they cause and increase in HbA1c

no - usually the benifits outweigh the risks

19

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

discontinue if serum transaminases are 3x upper limit of normal

20

3 monitoring tests for statins

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

21

drugs that interact with statins

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

22

what statin can be sold OTC

simv 10

23

max doses of simvastatin with other drugs stated in the BNF

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

24

which statin interacts with clopidogrel?
what is the max dose

maximum dose of rousovastatin with clopidogrel
20mg