Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Drug > Dyslipidemia > Flashcards

Dyslipidemia Flashcards

(50 cards)

Start Studying
1
Q

which station(s) is consider high intensity?

A

atorvastatin and rosuvastatin

  • high intensity means it can lower LDL > 50% from baseline**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what to do if patient has muscle myopathy with statin?

A

Hold med, wait 2 to 4 weeks, re-challenged at same or lower dose

can re-challenged twice, second re-challenged at lower dose

after 2nd re-challenged –> avoid statin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Can you re-challenged if patient has myopathy with statin?

A

yes

  • you can re-challenged twice*
  • 2nd re-challenged at lower dose*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

atorvastatin max dose

A

80 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

lovastatin max dose

A

80 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pravastatin max dose

A

80 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

rosuvastatin max dose

A

40 mg

  • Asian patient - may need to lower dose - exposure are 2x higher in Asian*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

simvastatin max dose

A

40 mg

** do not use 80 mg**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which 3 statins are CYP 3A4 substrates

A

ASL

atorvastatin
simvastatin
lovastatin

** pravastatin and rosuvastatin have less interaction **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

explain amlodipine and statin (ASL) interaction

A

amlodipine inhibits 3A4

ASL (ator, simv, lova) - substrate of 3A4

amlodipine can increase level of ASL

Max dose:
atorvastatin 10 mg
simvastatin 20 mg
Lovastatin 40 mg

** note: these are also equivalent dose**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

G❤PACMAN

  • helps you identify?
  • each stands for
A

CYP 3A4 inhibitors (strong)

G - grapefruit
P - protease inhibitor (HIV tx)
A - azole antifungal
C - cyclosporine, cobicstat
M - macrolide (x azithromycin)
A - amiodarone
N - Non DHP CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ezetimibe moa

A

blocks absorption of cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

simvastatin and eGFR

A

eGFR < 60

** do not exceed simv 20 mg**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ezetimibe + gemfibrozil intxn

A

increase risk of cholelithiasis

** do not use combo**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

explain MOA of PCSK9 maB

  • Alirocumab (Praluent)
  • Evolocumab (Repatha)
A

PCSK9 - is an enzyme that breaks down LDL receptors when it binds to LDL receptors

LDL receptors clears circulating LDL

** PCSK9 maB (inhibitors) prevent PCSK9 from binding to LDL receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long can Praluent and Repatha be store at room temp

A

30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bile acid sequestrant MOA

  • Colesevelam (Welchol)
  • Cholestyramine (Prevalite)
  • Colestipol (Colestid)

define sequestrant?

A

Sequestrant - binds to or absorp

Bile acid sequestrants bind to bile acid, prevents its reabsorption

Body has to use more cholesterol to make bile acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Welchol (colesevelam) indications

A

cholesterol

DIABETES
* also approved for glycemic control in type 2 DM
* decrease AC1 ~ 0.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

bile acid sequestrants
* colesevelam (Welchol)
* Cholestyramine (Prevalite)
* Colestipol (Colestid)

Clinical: when not to use

A

DO NOT USE when Triglyceride is > 300 mg/dL

Bile acid sequestrants increase TG ~ 5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How to take bile acid sequestrants?

Interactions with other drugs

A

Mix with water and take with FOOD

Take all other drugs at least 4 hours before or 4 hours after bile acid sequestrants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fibrates MOA

  • Fenofibrate
  • Fenofibric Acid
  • Gemfibrozil
Study These Flashcards
A

PPAR-alpha agonist

upregulate expression of lipoprotein lipase activity (increase activity)

Lipoprotein lipase - breaks down VLDL

This decreases TG, but can increase LDL in the setting of very high TG

22
Q

Catabolism define

Study These Flashcards
A

the breakdown of complex molecule in body

23
Q

Fibrates

Clinical notes

Study These Flashcards
A

decrease TG ~ 50%

can increase LDL in the setting of very high TG

Gemfibrozil SHOULD NOT be use with ezetimibe or statin

24
Q

Fibrates can affect ___ and ___

Study These Flashcards
A

Sulfonylureas
* fibrates can increase hypoglycemic affect

Warfarin

25
Niacin is also known as __ or __
nicotinic acid Vitamin B3
26
Niacin MOA
decrease hepatic synthesis of VLDL decrease TG and decrease LDL
27
3 Warnings with Niacin
Rhabdomyolysis * when combine with statin when doses > 1 gram/day Hepatotoxicity Increase BG, uric acid
28
How to prevent flushing with niacin
take ASA 325 mg or motrin 200 mg 30 to 60 minutes before niacin take with FOOD, avoid spicy food
29
Fish oils are also known as ____
omega-3 fatty acids
30
fish oils MOA * Lovaza: omega-3 Acid Ethyl Esters * Vascepa: Icosapent Ethyl
Reduce hepatic synthesis of TG
31
32
differences between Lovaza and Vascepa
Lovaza * increase LDL * contains DHA and EPA Vascepa * EPA - see in name * approved for ASCVD risk reduction * NO LDL increase Both increased risk of bleeding - stop prior to surgery
33
fish oil main drug interaction (1)
prolong bleeding time * use caution with other drugs that can increase bleeding risk
34
Bempedoic Acid MOA
inhibits cholesterol synthesis in the liver inhibits an enzyme call ACL * adenosine triphosphate-citrate lyase * upstream of HMG-CoA reductase
35
Bempedoic Acid + Statin Clinical
bempedoic Acid - approved for HeFH or ASCVD in combo with statin HeFH - Familial Hypercholesterolemia
36
Bempedoic Acid clinical SE (2)
Hyperuricemia - gout Tendon rupture
37
Inclisiran (Leqvio) MOA
inhibits intracellular production of PCSK9 via RNA interference * result in increased activity of LDL receptors PCSK9 - an enzyme that degrades LDL receptors (LDL receptors - clear circulating LDL)
38
Inclisiran (Leqvio) + PCSK9 maB * what do you think?
Do not use with PCKS9 mAb due to overlapping moa
39
Bile Acid sequestrants reduces absorption of what vitamins
Fat-soluble vitamins ADEK
40
Gemfibrozil (lopid) 2 clinical side effects
cholelithiasis (gallstone) Pancreatitis
41
How to take Niacin ER
take at bedtime after a low-fat snack
42
Niacin 3 clinical SE
Hyperglycemia Liver Damage Flushing * flush free niacin is not effective
43
why is HDL good? what is its function
HDL (protein): high density lipo-protein * takes cholesterol from the blood and delivers it to the liver for removal from the body * high HDL lowers ASCVD risk Desirable level > 40 (men) > 50 (women)
44
High TG > 500 mg/dL can cause __
acute pancreatitis
45
Normal (goal) cholesterol level LDL HDL TG
LDL < 100 * > 190 is very high HDL * > 40 men * > 50 women TG < 150 * > 500 is very high
46
2 drugs that can increase LDL
Fibrates Fish oils (x Vascepa)
47
BMI goal
BMI < 25
48
3 OTC products (herbal) for cholesterol
Red yeast rice - contains naturally occurring HMG-CoA reductase inhibitors (statin) Fish oils - can lower TG - INCREASE LDL Garlic - marketed BUT NOT effective
49
Statin equivalent dose Rosuvastatin Atorvastatin Simvastatin Lovastatin Pravastatin
Rosuvastatin: 5 mg Atorvastatin: 10 mg Simvastatin: 20 mg Lovastatin: 40 mg Pravastatin: 40 mg ** lovastatin and pravastatin 1:1 ratio
50

Drug (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions