Exam 3; Agents used to treat Hyperlipidemias Flashcards Preview

AU14 Pharmacology > Exam 3; Agents used to treat Hyperlipidemias > Flashcards

Flashcards in Exam 3; Agents used to treat Hyperlipidemias Deck (46):
1

What causes hyperlipidemia

a defect in the lipid transport system which provides cholesterol and triglycerides to the cell

2

There is an increased risk of these three things with an increase in blood lipids

coronary artery disease; due to increased plaque formation
pranceatitis
xanthoma; deposition of fat in the skin

3

This form on lipoprotein when in high levels, causes more potential problems

LDL; low density lipoproteins

4

What is the desirable level of LDL

< 100mg/DL

5

What converts chylomicrons ti free fatty acids

lipoprotein lipase

6

The chylomicron remnants (cholesterol) travel to which organ

the liver

7

These two things combine to form vLDL

apolipoprotein and cholesterol

8

What is the intermediate step in the formation of LDL from vLDL

vLDL → IDL → LDL
steps all catalyzed by lipoprotein lipase

9

If LDL becomes oxidized, what occurs

it is taken up by macrophage and deposited on arterial linings

10

What is a major carrier of cholesterol

LDL

11

LDL binds to what on the cell

LDL receptor

12

This enzyme in the cells can make cholesterol

HMG CoA reductase

13

Cholesterol can make these oh which can go into the gut

bile acids

14

What is considered the "good cholesterol"

HDL
high density lipoproteins

15

What four things cause secondary hyperlipoproteinemias

cirrhosis
alcoholism
nephrosis
diabetes

16

What are four things that cause primary hyperlipoproteinemias

decreased lipoprotein lipase
abnormal LDL receptors
over production of vLDL
decreased HDL synthesis

17

What are two non-pharmacologic treatments of hyperlipoproteinemias

diet/exercise
stop smoking

18

What are three mechanisms behind pharmacologic effects of drugs treating hyperlipoproteinemia

decrease production of lipoproteins
increase removal of lipoproteins/cholesterol
decrease absorption of lipoproteins

19

Can agents that treat hyperlipoproteinemias affect the fetus

Yes

20

What will happen to the effects of hyperlipoproteinemia drugs upon stoppage of taking them

the effects will stop as well

21

Which family of drugs are the HMG CoA reductase inhibitors

"-statin's"

22

True or False
the HMG CoA reductase inhibitors (-statins) are the most effective LDL lowering agents

True

23

What is the mechanism of action behind the statin drugs

inhibits HMG CoA reductase; the rate limiting step in the cell synthesis of cholesterol

24

When the cells cannot make their own cholesterol, how do they compensate

they increase the LDL receptors on the cell

25

What is a major side effect of the statin drugs

myositis; muscle pain
especially true since many are metabolized by P450

26

What are three side effects of statin drugs

liver toxicity
teratogenis; pregnancy category X
some memory loss

27

What is the main difference between all the statin drugs

pharmacokinestics

28

What is the mechanism of action behind niacin

it inhibits an enzyme essential for vLDL synthesis and may also bind to a receptor that decreases vLDL synthesis

29

What is the result of using niacin

decrease in vLDL
increase in HDL; strongest increaser of HDL

30

What are four side effects of Niacin

cutaneous flushing (red face)
itching
increased uric acid; gout
increase incidence of diabetes

31

What are the three bile acid binding resins

cholestyramine
colestipol
coleselevam
"coles"

32

What is the mechanism of action behind the "coles"

irreversibly bind to bile acids in the gut; are excreted along with their cholesterol

33

What two things do the "cole" drugs cause

decrease in circulating cholesterol
increase in LDL receptors

34

What are the side effects of the "cole" drugs

no side effects because they are not absorbed; but can cause nausea or GI irritants

35

This family of drugs are the best triglyceride lowering agents

the fibrates

36

What is the mechanism behind the fibrates

binds to PPAR; perixosome proliferator activating receptor
increasing the activity of LPL

37

What are the fibrates

gemfibrozil
fenofibrate
(both have fibr)

38

What are two side effects of gemfibrozil and fenofibrate

GI upset
can displace warfarin from plasma binding sites

39

These two things decrease triglyceride synthesis via inhibition of an enzyme

omega 3 fatty acids
icosapent ethyl

40

This essentially inhibits assembly of vLDL in the liver; both an enzyme and a transporter

imoitapide

41

This is an anti-sense oligonucleotide

mipomersen

42

What is the mechanism of mipomersen

binds to the mRNA for apoloprotein-B; preventing it from being synthesized

43

This drug blocks cholesterol transport

ezetimibe

44

This drug looks like cholesterol and blocks its uptake

sitostanl

45

This inhibits GI and pancreatic lipase, decreasing fat absorption from the gut and causes loose stools

orlistat

46

This is an non-absorbable oil used for frying/cooking but causes anal leakage → gross.

olestra