Dyslipidemia Pharm

Question 0

Fibrates

Answer 0

Demfibrozil, Fenofibrate
MOA: decreases VLDL production and increases lipoprotein lipase activitiy
-used for tx of very high trigs and/or low HDL
AE: GI upset, myalgias (esp when combined w/ statins)
CI: simvastatin and lovastatin

Question 1

Statins

Answer 1

Rosuvastatin, Atorvastatin, Simvastatin, Pravastatin, Fluvastatin
-HMG-CoA reductase inhibitor, reduces cholesterol synthesis, decreases overall lipoprotein production, blocks cholesterol synthesis in liver, reduces mainly LDL and TC, plaque stabilizing, decreased thrombogenicity, improves endothelial function
AE: elevated transaminases, muscle injury
CI: active liver disease, preg,
Interactions w/ ketaconazole, erythromycin, gemifbrozil, amlodipine, diltiazem

Question 2

Bile Acid Sequestrants

Answer 2

Cholestyramin, Colestipol, Colesevelam

• Tx of elevated LDL
• Binds bile acids and prevents reabsorption
• Older drug mc used when other tx fail
• AE: constipation, nause can interfere w/ other drugs

Question 3

Cholesterol Absorption Inhibitors

Answer 3

Ezetimibe or Ezetimibe + Simvastatin

• Tx of elevated LDL
• Blocks the absorption of ditary or biliary cholesterol at the brush border of intestine
• AE: diarrhea, myalgias, arthralgias

Question 4

Nicotinic Acid

Answer 4

Niacin (Vit B3)

• Tx of elevated trigs or LDL and low HDL
• inhibits the production of VLDL and its subsequent LDL
• titrate over 4-8 weeks
• Only be used as extended release
• AE: flushing, itching, warm feeling
• avoid w/ alcohol, saunas, spicy foods, increases plasma glucose, increases uric acid levels

Question 5

Omega-3 Fatty acids

Answer 5

Fish oils, Lovaza (prescrip)
Tx of very high trigs
-decrease VLDL and increase lipoprotein lipase activity
-should contain high amts of EPA and DHA
AE: bad taste, slight anti-platelet activity