Cholesterol Drugs Flashcards
(27 cards)
What are common generics of statins?
Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Rosuvstatin, Simvastin
What is the MOA of statins?
Inhibit 3-hydroxy-3-methylglutarylecoenzyme A (HMG CoA) reductase, inhibts the enzyme that controls cholesterol production in the body
How do statins affect the liver?
Increases liver’s ability to remove LDLs from blood by increasing LDL receptors
What is the first line treatment for lowering LDL?
Statins (25-40%)
What are statins indicated for?
Reduce mortality and morbidity in patients with and without CAD, improve endothelial function, modulate inflammation, maintain plaque stability, and prevent thrombosis
What are the adverse effects of statins?
Diarrhea or constipation, possible arrhythmias, myalgia, muscle cramps and tendonitis, abnormal liver function, rhabdomyolysis (breakdown of skeletal muscle)
What are statins contraindicated for?
Pregnancy, liver dysfunction
Why are statins of use to optos?
Have been shown to increase retinal blood circulation, may be useful for ischemic retinal disease, may protect against AMD, may decrease incidence of diabetic neuropathy, caution when prescribing erythromycin and clarithromycin- increase statin levels in blood
What are common generics of bile acid binders?
Cholestyramine, Colestipol, Colesevelam
What is the MOA of bile acid binders?
Bind with cholesterol with bile in small intestine and excrete it through the feces, prevents absorption into circulation
What does the liver do in response to bile acid binders?
The liver then produces more bile to replace what has been lost, because the liver needs cholesterol to make bile, it uses up the cholesterol in the blood, which reduces circulating LDLs
What are bile acid binders indicated for?
Often prescribed with statins (additive effect), lower LDL (10-25%), minimal effect on HDL (3-5%), no effect on triglycerides- may elevate over time
What are adverse effects of bile acid binders?
Constipation, bloating and gas, interfere with absorption of other drugs (vitmains D, A, K, and E)
What are bile acid binders contraindicated for?
Constipation
Why are bile acid binders of use to optos?
Vitamin supplementation may be warranted, other drugs affected: beta-blockers, tetracycline, cephalosporins, acetaminophen, oral contraceptives
What are common generics of fibrates?
Gemfibrozil, Fenofibrate, Fenofibric acid
What is the MOA of fibrates?
PPAR- alpha receptor agonists, facilitate lipid metabolism, increase HDL levels (10-35%), lower LDL levels (5-20%), decrease hepatic triglyceride secretion (20-50%)
What are the indications of fibrates?
Often combined with statins, useful as monotherapy if patient can’t take statins, can help improve insulin resistance (related to thiazolidinediones)
What are adverse effects of fibrates?
May increase risk of myopathy when combined with statins, gas and bloating, bleeding and anemia, gallstone formation, hypoglycemia
What are fibrates contraindicated for?
Liver disease, gallbladder disease, pregnancy
Why are fibrates of use to optos?
May protect against diabetic retinopathy (45% reduction in some reports), decreases need for laser therapy in diabetic retinopathy
What is the generic form of nicotinic acid?
Niacin
What is the MOA of nicotinic acid?
B vitamin given at high dose (1.5-3 grams/day)
What is nicotinic acid indicated for?
Decrease production of LDL (5-25%), decreases triglycerides (20-50%), increases HDL levels (15-35%) more than other lipid-lowering meds, increases effect of anti-hypertension meds (vasodilator)
