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Flashcards in Drugs For Hyperlipidemia Deck (30):
0

Chylomicrons or LDL
Premature atherosclerosis: increased ___________
Acute pancreatitis: increased ___________

LDL
Chylomicrons

1

Primary dietary factors that contribute to elevated plasma lipoproteins

Cholesterol
Saturated fats

2

Alcohol raises _______ and ________ levels and should be avoided in pxs with high __________

TG and VLDL
TG

3

Drugs most effective at lowering LDL

Statins
Resins
Ezetimbe
Niacin

4

Drugs most effective at lowering TG and VLDL and raising HDL

Niacin
Fibrates

5

Increases number of high affinity LDL receptors which clear LDL and VLDL temnants from the blood
Inhibits hepatic cholesterol synthesis

Drug, Class

Simvastatin, HMG-CoA Reductase Inhibitor
(Atorvastatin, Rosuvastatin, Fluvastatin, Pravastatin, Lovastatin, Pitavastatin)

6

Reversible competitive inhibitor of HMG-Coa reductase
Increased hepatic cholesterol uptake
Increased HDL, Decreased LDL
Drugs for High LDL
SE: Hepatotoxicity, myopathy, risk for rhabdomyolysis when used with fibrates
Drug, Class?

Simvastatin, HMG-CoA Reductase Inhibitor
(Atorvastatin, Rosuvastatin, Fluvastatin, Pravastatin, Lovastatin, Pitavastatin)

7

Why are statins given at night?

Cholesterol synthesis predominantly occurs at night

8

Binds bile acids and prevent their intestinal absorption, diverting hepatic cholesterol to bile acid synthesis
Increase in HDL, decreases LDL (modest)

Class?

Bile Acid Binding Resins

9

Binds bile acids, increasing cholesterol use for their replacement
Modest lowering of LDL
Drug for hypercholesterolemia (high LDL) pruritus in cholestasis
SE: constipation, bloating, steatorrhea
Increases TGs and VLDL in patients with high TGs
Avoid in pxs with diverticulitis
Side effect of constipation can be treated with fiber supplements/psyllium


Drug, Class

Cholestyramine, Bile Acid Binding Resins
(Colesevelam, Colestipol)

10

Inhibits NPC1L1 transporter (in the jejunal enterocyte) that mediates gastrointestinal uptake of cholesterol and phytosterols
Drug for high LDL
SE: hepatotoxicity (increases with statin use)
Synergistic LDL lowering effect with statins

Drug, Class

Ezetimibe, Cholesterol absorption blocker

11

Cholesterol analog
Takes the place of dietary and biliary cholesterol
Drug for high LDL
SE: GI upset, bloating

Drug, Class

Sitosterol, Sterol absorption blocker

12

Most effective agent for increasing HDL levels
Reduces LDL cholesterol, triglycerides and VLDL
SE: flushing, hyperuricemia, impaired glucose tolerance, arrhythmia
Avoid in pxs with PUD
Potentiates effects of anti-hypertensives

Niacin, antihyperlipidemic drug

13

Pre-treatment with _________ causes reduction of flushing as a side effect of Niacin

Aspirin

14

Drugs that cause flushing

VANC
Vancomycin
Adenosine
Niacin
CCB

15

Increases synthesis of lipoprotein lipase, enhancing clearance of triglycerides
Stimulates fatty acid oxidation, limiting supply of TG and decreases VLDL synthesis
Increases HDL levels
Little or no effect on LDL

Class?

Fibrates

16

Activate PPAR-alpha
DOC for hypertriglyceridemia (low HDL, high LDL)
SE: increased risk for Cholesterol gallstones
Increased risk of myopathy and rhabdomyolysis when used with statins
Avoid in pxs with hepatic and renal dysfunction

Gemfibrozil, Fibrates
(Fenofibrate, Bezafibrate)

17

All patients with hyperlipidemia are treated first with _______________

Dietary modification

18

Synergistic drug combinations for Familial Hypercholesterolemia

Niacin + Statin
Statin + Ezetimibe

19

Synergistic drug combinations for Familial Combined Hypercholesterolemia

Niacin + Resin
Statin + Fibrate

20

Antihyperlipidemic combination at increased risk of cholelithiasis

Fibrate + Resin

21

Antihyperlipidemic combination causing impaired statin absorption

Statin + Resin

22

Antihyperlipidemic combination at increased risk of myopathy and rhabdomyolysis

Statin + Fibrate

23

DOC for high LDL or VLDL, or both

Statins

24

DOC for high TG

Fibrates

25

DOC for low LDL

Niacin

26

Primary hyperchylomicronemia
Primary Tx?
Secondary Tx?

Low-fat diet

Niacin + Fibrate

27

Familial Hypercholesterolemia
Primary Tx?
Secondary Tx?

Statin

Niacin
Ezetimibe

28

Familial dysbetalipoproteinemia
Primary Tx?
Secondary Tx?

Fibrate + Niacin

Statin

29

Familial hypertriglyceridemia
Primary Tx?

Fibrates + Niacin