Drugs for Dyslipidemias

Question 1

When did the Framingham Heart Study begin?

Answer 1

1948

Question 2

What cardiovascular risk factor was directly linked to coronary heart disease (CHD) in 1961?

Answer 2

High LDL levels

Question 3

How does HDL relate to CHD risk?

Answer 3

Inverse relationship (higher HDL = lower CHD risk)

Question 4

Do high triglycerides (VLDL) increase CHD risk?

Answer 4

Yes, but not as strongly as LDL

Question 5

What are the main functions of cholesterol?

Answer 5

Provides membrane rigidity
Precursor to steroid & stress hormones, vitamin D
Precursor to bile acids for fat digestion

Question 6

What percentage of cholesterol is produced by the body vs. obtained from the diet?

Answer 6

80% endogenous synthesis, 20% from diet

Question 7

Why is LDL called “bad cholesterol”?

Answer 7

Contributes to plaque buildup in arteries → increases CHD risk

Question 8

What is the risk threshold for LDL levels?

Answer 8

> 130 mg/dL increases CHD risk

Question 9

Why is HDL called “good cholesterol”?

Answer 9

Removes excess cholesterol from tissues → lowers CHD risk

Question 10

What is the risk threshold for low HDL levels?

Answer 10

<40-50 mg/dL increases CHD risk

Question 11

How do high triglycerides (VLDL) impact health?

Answer 11

Increase risk of CHD and pancreatitis

Question 12

What percentage of total calories should come from fat to lower LDL?

Answer 12

<30%

Question 13

What is the recommended daily cholesterol intake?

Answer 13

<200 mg/day

Question 14

What dietary components help reduce LDL levels?

Answer 14

Fiber & plant sterols (e.g., Benechol™, Smart Balance®)

Question 15

What other components help reduce LDL levels?

Answer 15

Omega 3 fatty acid oils (fish oil)
Exercise and calorie reduction

Question 16

What is the first-line medication for lowering LDL?

Answer 16

Statins

Question 17

How do bile acid sequestrants lower LDL?

Answer 17

Bind bile acids, forcing the body to use cholesterol to make more

Question 18

What do PCSK9 inhibitors do?

Answer 18

Increase LDL receptor activity, enhancing LDL clearance

Question 19

How does ezetimibe work?

Answer 19

Inhibits cholesterol absorption in the intestine

Question 20

What are three common statins?

Answer 20

Atorvastatin (Lipitor®)
Rosuvastatin (Crestor®)
Simvastatin (Zocor®)

Question 21

What enzyme do statins inhibit?

Answer 21

HMG-CoA reductase

Question 22

How do statins lower LDL levels?

Answer 22

Inhibit cholesterol synthesis → Liver upregulates LDL receptors → More LDL is removed from the blood

Question 23

What is the net effect of statins?

Answer 23

Reduced serum LDL → Decreased CHD risk

Question 24

What is the most severe adverse effect of statins?

Answer 24

Rhabdomyolysis (muscle breakdown → kidney failure)

Question 25

What are common mild side effects of statins?

Answer 25

Muscle weakness & pain

Question 26

What rare liver-related side effect can statins cause?

Answer 26

Hepatotoxicity

Question 27

Which medications can increase statin levels?

Answer 27

Antifungals & antibiotics that inhibit CYP3A4

Question 28

What is the most effective drug class for lowering triglycerides?

Answer 28

Fibrates (Gemfibrozil, Fenofibrate)

Question 29

How do fibrates lower triglycerides?

Answer 29

Activate PPAR-α → Increases fatty acid metabolism → Lowers VLDL levels

Question 30

How do fish oil supplements help lower triglycerides?

Answer 30

Work similarly to fibrates by increasing fatty acid metabolism

Question 31

What is the AHA recommendation for omega-3 intake?

Answer 31

Two servings of fatty fish per week

Question 32

Which statins can also lower triglycerides?

Answer 32

Atorvastatin & Rosuvastatin (less effective than fibrates)

Question 33

How do high triglycerides increase CHD risk?

Answer 33

Contribute to arterial plaque formation

Question 34

What serious condition can occur if triglycerides exceed 500 mg/dL?

Answer 34

Acute pancreatitis

Question 35

Are statins only used for treating heart disease?

Answer 35

No, they are also prescribed for prevention.

Question 36

Why should dentists be aware of patients taking statins?

Answer 36

Potential drug interactions & comorbidities (hypertension, diabetes, atherosclerosis).

Question 37

Which antifungals and antibiotics can inhibit statin metabolism?

Answer 37

Fluconazole, Itraconazole, Erythromycin

Question 38

Why is inhibiting statin metabolism a concern?

Answer 38

Increases statin plasma levels → Higher risk of muscle toxicity