Dyslipidemia Flashcards Preview

Pharm II MHM - FINAL > Dyslipidemia > Flashcards

Flashcards in Dyslipidemia Deck (37):
1

Omega-3 MOA

-Lowers TG by 60%
-Unclear how exactly - decreases hepatic circulation of TGs OR decreases TG synthesis

2

ADEs of omega 3

Fishy burp
Indigestion

3

When are omega 3s given?

TG over 500 mg/dL

4

Cholesterol absorption inhibitor MOA and examples

Decrease intestinal absorption of dietary and biliary cholesterol
(Ezetimibe)

5

Metabolism of cholesterol absorption inhibitors

Glucuronidation w/an active metabolite
(advantage - NO CYP)

6

Which lipid lowering med is metabolized via glucuronidation (therefore no CYP interactions)?

Cholesterol absorption inhibitors

7

Cholesterol absorption inhibitors and ASCVD risk

Lowers LDL but NOT proven to lower ASCVD risk

8

Fibrates MOA and examples

-Activate PPAR-alpha (metabolism/catabolism of lipids)
-Gemfibrozil, fenofibrate

9

Nicotinic acid MOA

Decreases TG synthesis (maybe in adipose tissue?)

10

ADEs of nicotinic acids

Flushing, N/V, myopathy

11

How to combat flushing with nicotinic acid?

Take full dose of aspirin (325 mg)

12

Bile acid sequestrants MOA and examples

-Anion exchange resins that bind to bile acids (excreted in feces)
-Cholestyramine, colestipol

13

How are bile acid sequestrants metabolized?

Not absorbed or metabolized (excreted in feces)

14

ADEs of bile acid sequestrants

GI - flatulence, abdominal pain, constipation, N/V

15

Statins MOA

Inhibit HMG-CoA reductase (rate limiting step of cholesterol synthesis)

16

ADEs of statins

Dizziness, HA, abdominal pain, myopathy

17

Statins lowest to highest potency

Fat People Love Seconds At Restaurants
(also the order of short to long half life)

18

Which statin is NOT CYP metabolized?

Pravastatin (sulfation)

19

Which statin has LOW protein binding?

Pravastatin

20

Which statins are NOT lipophilic?

Pravastatin
Rosuvastatin

21

Substances that INCREASE statin concentrations

Nicotinic acid, fibrates
Azole antifungals
Macrolide abx
Amiodarone
Grapefruit juice
ETOH

22

What labs should be checked at baseline prior to a lipid lowering med being added?

Fasting lipid panel
ALT
CK
Glucose (fasting or A1c)

23

What lab should be checked at baseline prior to adding niacin?

Uric acid

24

What lab should be checked at baseline prior to adding bile acid sequestrants?

TGs

25

What lab should be checked at baseline prior to adding fibrates?

Serum Cr or GFR

26

Factors useful for assessing ASCVD risk

Family hx
CRP over 2
CAC over 300
ABI less than 0.9

27

Factors that are NOT useful for assessing ASCVD risk

ApoB
CKD
Albuminuria
Cardiorespiratory fitness
Carotid intima media thickness (CIMT)

28

How should adults 20-79 yo w/o current ASCVD be screened?

Assess traditional risk factors every 4 to 6 years

29

How should adults 40-79 yo w/o current ASCVD be screened?

Estimate 10 yr ASCVD risk every 4-6 years

30

Patient education on prescribing a statin?

It is to reduce risk of heart attack and stroke

31

Patients on a statin should contact provider when what occurs?

Unexplained muscle pain
Change in urine color (dark brown)

32

Safety monitoring of statins

-ALT and AST (only as needed)
-Myopathy symptoms (test CK as needed)

33

What is the goal of treatment if TGs are over 1000 mg/dL?

Emergent! Avoid acute pancreatitis
-Goal is to decrease TG levels rather than long term prevention of ASCVD
-Use fibrates (niacin and omega 3 can also be considered)

34

How is the ASCVD 10 yr risk used?

ONLY in statin naive patients

35

What intensity statin in 40-75 yo and ASCVD over 7.5%?

Moderate OR high intensity

36

What intensity statin in 40-75 yo with DM?

Moderate intensity

37

What intensity statin in 21 yo or older and LDL over 190?

High