Drugs to Treat HLD

Question 1

What is the normal range for HDL cholesterol in men and women over the age of 20?

Answer 1

> 40 for men and >50 for women; diagnostic criteria for metabolic syndrome if low

Question 2

What are negative risk factors for CAD?

Answer 2

if HDL is >60

Question 3

Which agent is the best choice for increasing HDL cholesterol?

Answer 3

Niacin

Question 4

What is the appearance of plasma after a high fat meal?

Answer 4

Milky due to chylomicrons (i.e. their density)

Question 5

What is the role of VLDL?

Answer 5

Synthesized and secreted by the liver to deliver TAG and cholesterol/cholesterol ester to the periphery

Question 6

Why is niacin no longer recommended for treating dyslipidemia?

Answer 6

Because of the fact that CHD mortality was not decreased by niacin in some large clinical trials

Question 7

What keeps systemic levels of statins low while those in the liver high enough to exert their effects?

Answer 7

Enterohepatic circulation

Question 8

How is sitosterolemia treated?

Answer 8

A rare condition where the body stores plant sterols and its homozygous form is treated with Ezetimibe

Question 9

What is the 5th leading cause of death?

Answer 9

Stroke and its risk is increased by high cholesterol levels

Question 10

What adverse GI side effect is caused by bile acid sequestrants cholestyramine and colestipol?

Answer 10

Severe constipation

Question 11

What is Fluvastatin?

Answer 11

HMG-CoA reductase inhibitor, low med subclass

Question 12

What is a noteworthy cause of hypetriglyceridemia?

Answer 12

Drugs

Question 13

What is the percentage of LDL-C lowering seen with drugs such as simvastatin and lovastatin?

Answer 13

Low med

Question 14

Elevated glucose levels while fasting is a diagnostic criteria for what?

Answer 14

metabolic syndrome

Question 15

What FA is in fish oil?

Answer 15

Docosahexaenoic acid

Question 16

Feces has increased levels of bile acids when drugs such as what are used to lower plasma cholesterol levels?

Answer 16

Colesevelam

Question 17

What is the role of PCSK9?

Answer 17

synthesized by the liver and is secreted; it can then bind to LDL-R on the hepatocytes surface to trigger their destruction when endocytosed

Question 18

What drug class competitively blocks the formation of mevalonate (the first and RLS of cholesterol synthesis) aka HMG-CoA reductase inhibitors?

Answer 18

Statins

Question 19

Which fibrate exerts its effects in part via activation of PPAR-alpha?

Answer 19

Fenofibrate

Question 20

An apple physique is used to describe people with what condition?

Answer 20

metabolic syndrome

Question 21

What is common with injections of monoclonal Abs?

Answer 21

injections reactions; seem to be more frequent for alirocumab than evolocumab

Question 22

Polygenic characterizes most instances of hereditary hypercholesterolemia other than those commonly referred to as what?

Answer 22

familial

Question 23

Colesevelam is a bile acid sequestrant with fewer what than others in this class?

Answer 23

Adverse effects

Question 24

Which drug should never be used with a statin?

Answer 24

Gemfibrozil (fibrate that exerts its effects in part via activation of PPAR alpha)

Question 25

What is PPAR-alpha?

Answer 25

transcriptional activator that mediates some if not most of the beneficial effects observed with fibrate therapy of hypertriglyceridemia

Question 26

Consuming fish oil can help lower what?

Answer 26

plasma triglyceride levels via inhibition of hepatic VLDL synthesis

Question 27

What is a rare inherited disorder that would preclude the use of colesevelam to lower plasma cholesterol levels?

Answer 27

Phenylketonuria

Question 28

What formation of niacin was associated with the more severe instances of hepatotoxicity?

Answer 28

Sustained release

Question 29

what is the process by which cholesterol enters the cell?

Answer 29

Endocytosis facilitated by a clarthin coat

Question 30

What is an unqualified reason to administer fibrates to a pt?

Answer 30

acute pancreatitis; risk for this condition is increased by hypertriglyceridemia especially when plasma levels exceed 1000

Question 31

Why are lornitapide and mipomersen classified as orphan drugs?

Answer 31

Because of their use to treat rare homozygous familial hypercholesterolemia

Question 32

What transports chylomicrons to the bloodstream?

Answer 32

lymph

Question 33

What can help lower plasma triglyceride levels?

Answer 33

weight loss

Question 34

What is an example of snack that should be avoided to lower plasma cholesterol levels?

Answer 34

chocolate

Question 35

Which apolipoprotein is added to VLDL?

Answer 35

B100 and serves as a ligand for LDL receptor

Question 36

What is the role of lipoprotein lipase?

Answer 36

Located in the peripheral capillaries and stimualted by apo-CII; converts triglycerides to FFA for uptake by peripheral cells

Question 37

Common varieties of what food should be avoided to lower cholesterol?

Answer 37

Cheese

Question 38

What is an adverse effect associated with the use of gemifibrozil and statins?

Answer 38

myopathy; not observed when fenofibrate is used with statins

Question 39

What hormone raises triglyceride levels in women?

Answer 39

estrogens

Question 40

Which class of agents can help raise triglyceride levels?

Answer 40

Bile acid sequestrants; contraindicated if triglyceride levels are already significantly elevated (>400)

Question 41

What drug class is first choice when treating pts with hypercholesterolemia?

Answer 41

statins

Question 42

What is an example of a PCSK9 inhibitor?

Answer 42

Evolocumab

Question 43

LDL cholesterol is normally what value?

Answer 43

<100 in adults over the age of 20