Duan: Antihyperlipidemic Drugs Flashcards Preview

Block 9 Week 2 Meg > Duan: Antihyperlipidemic Drugs > Flashcards

Flashcards in Duan: Antihyperlipidemic Drugs Deck (25)
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1
Q

What are these?

lovastatin
simvastatin
pravastatin
fluvastatin
atorvastatin
rosuvastatin
A

HMG-CoA reductase inhibitors

**inhibit conversion of HMG-CoA to mevalonate, a cholesterol precursor

2
Q

What do HMG-CoA reductase inhibitors do to LDL, HDL, and TAGs?

A

decrease LDL
increase HDL
decrease TAGs

3
Q

What are these?

cholestyramine
colestipol
colesevelam

A

bile acid resins

4
Q

How do bile-acid resins work?

A

essentially they bind bile acids in the intestine, prevent their intestinal absorption, and increase their fecal secretion

**this causes the liver to use cholesterol to make more bile acids (results in increased production of LDL receptors and an increase in activity of HMG-CoA reductase)

5
Q

What is the main effect of bile acid resins, in regards to LDL, HDL, and TAGs?

A

decreases LDL!
modest increase in HDL and TAGs

**used in patients with elevated LDL

6
Q

Inhibits lipolysis in adipose tissue; reduces hepatic VLDL synthesis leading to decreased LDL

A

niacin

**use reduces apoB-containing lipoprotein (VLDL, IDL, LDL) synthesis

7
Q

What does niacin do to LDL, HDL, and TAGs?

A

decreases LDL and TAGs, slight increase in HDL

  • *used to treat most forms of hyperlipoproteinemia (except familial lipoprotein lipase deficiency)
  • *drug of choice for hypertriglyceridemia associated with elevated chylomicrons
8
Q

One side effect to consider with nicotinic acid (niacin)?

A

intense cutaneous flush (red flushed face) and itching

**can also cause hyperglycemia and hyperuricemia

9
Q

List two fibrates we should know about

A

Gemfibrozil

Fenofibrate

10
Q

What is the mechanism of action of fibrates?

A

activate PPAR-alpha to induce HDL synthesis
upregulate LPL to decreases TAGs

**increase HDL
decrease LDL and TAGs

11
Q

When are fibrates useful?

A

for lowering VLDL levels in patients with hypertriglyceridemia

12
Q

What is one BONUS to fibrate use?

A

they raise HDL!

13
Q

Selectively inhibits cholesterol absorption in the intestinal lumen at the enterocyte brush border

A

Ezetimibe

**decreases LDL

14
Q

Inhibits activity of intestinal lipases. A portion of the dietary fat is not digested and excreted with the feces

A

Orlistat

**used for treatment of obesity

15
Q

When is Orlistat contraindicated?

A

in pts with medical causes of obesity or gallbladder disease

16
Q

Gallstone solubilizing agent, which causes dissolution of radiolucent gallstones
Increases concentration at which saturation of
cholesterol occurs, so slowly dissolve.

A

Ursodiol

17
Q

What is the optimal LDL cholesterol level?
What is the optimal total cholesterol level?
What is the optimal HDL cholesterol level?

A

LDL:
less than 100

Total cholesterol:
less than 200

HDL:
>40 (men), >50 (women)

18
Q

Prescribed for lowering LDL
For heterozygous forms of familial hypercholestrolemia
For secondary hypercholesterolemia caused by diabetes mellitus

A

statins

19
Q

What should you combine statins with to have greater additive effects with up to 50% reduction in LDL levels?

A

bile-binding resin or ezetimibe

20
Q

When should statins be taken?

A

before bed!

**this is when the majority of cholesterol is synthesized

21
Q

What can cause the myopathy associated with statin use?

A

grapefruit or grapefruit juice which interferes with metabolism of statins in liver

22
Q

What should bile-acid binding resins be combined with to have an additive effect in lowering LDL?

A

niacin

statins

23
Q

Drug of choice for severe hypertriglyceridemia associated with elevated chylomicrons

A

Niacin

24
Q

Lowers triglycerides

Reduces levels of postprandial chylomicrons and VLDL

A

Omega-3 acid ethyl esters

25
Q

Define the requirements for metabolic syndrome

A

Any 3 of following risk factors:

Abdominal obesity – men >40”, women > 35”

TG greater than 150 mg/dL

HDL – men < 40 mg/dL, women < 50 mg/dL

Blood pressure greater than 130 / 85 mm Hg

Fasting glucose greater than 100 mg/dL