Flashcards in Dyslipidemia Deck (26)
What are drugs that increase LDL and decrease HDL as a side effect?
progestins, steroids, corticosteroids
What are causes of secondary dyslipidemia?
DM, hypothyroidism, liver disease, renal failure, drugs
Diabetes is considered what kind of a risk factor?
CHD-Eqiuvalent, LDL goal of <100
What is your 10-year risk if you have 2 risk factors? 1?
How often should a fasting lipid profile be performed in adults >20?
every 5 years
If a patient is non fasting for their lipid panel, which values are still accurate?
total cholesterol and HDL
What are the optimal cholesterol values?
total cholesterol 40, TG < 150
What is the LDL goal of a patient with 2+ risk factors?
What are dietary TLC changes we can recommend to our patients?
Reduce saturated fat and cholesterol, consider adding plant stanols/sterols, increase viscous fiber intake
Let's say you began a patient on TLC and saw them 6 weeks later in follow-up and they are still not at goal LDL. Do you start LDL-lowering therapy?
No. Reinforce dietary suggestions and consider referral to dietician. Drugs should not be initiated until 3rd visit if still not at goal LDL.
Patients with familial hypercholesteremia usually require combination therapy with which 2 drug types?
statin + bile-sequestering agent
Ideal triglycerides are <150. If a patient has TG of 150-200 what is the aim of therapy? If they are 200-499? over 500?
Try to achieve LDL goal first. Consider addition of fibrate or niacin. If over 500 want to prevent pancreatitis!
What is the primary target of therapy in patients with low HDLs?
LDLs. Once LDL is reached, then goal is weight reduction and increasing physical activity. FIbrates and niacin can help.
What are our concerns with a patient with familial hyperchylomicronemia?
Worry about them not getting their fat soluble vitamins, also can get severe pancreatitis. may require plasmaphoresis.
What are the MAJOR risk factors for atherosclerosis/CHD that count as risk factors in the framingham score?
smoking, HTN (or on anti-HTN med), HDL< 40, age (men>40, women >55)
What drug has the most LDL lowering effect?
Which drug has the most HDL raising effect?
Which drug has the most TG lowering effect?
What are common adverse effects of niacin?
flushing, gout (contraindicated if already have gout), hyperglycemia
What are adverse effects of statins?
myopathy, increased liver enzymes
Which drugs are contraindicated in patients with chronic liver disease?
Statins, niacin, fibrates
which drugs are BSAs?
Which drugs are HMG co-A reductase inhibitors?
Which drugs are fibric acid derivatives?
gemfibrozil, clofibrate, fenofibrate
What are other life habit risk factors that can increase your CHD risk? (not counted in 10-year risk)
obesity (BMI >30), diet high in cholesterol, physical inactivity, African American