Exam 6 - Drugs for Hyperlipidemia Flashcards

(42 cards)

1
Q

LDL and non-HDL goal for a person of lower risk: 0-1 risk factors

A

LDL goal: <160

non-HDL goal: 190

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

What is the only way to raise your HDL?

A

exercise; has no effect on LDL but increases HDL by 4-22%

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

Statins: MOA

A

HMG-CoA Reductase inhibitors

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

Do not use 80 mg dose

A

Simvastatin

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

As a group, what are statins the drug of choice for?

A

LDL reduction

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

Metabolized by 3A4

A

Atorvastatin
Lovastatin
Simvastatin

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

Metabolized by 2C9

A

Rosuvastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Statin adverse effects

A
  • Elevation in liver enzymes
  • Myopathy (myalgia, myositis, rhabdomyolysis)
  • cognitive dysfunction (age>50)
  • elevated blood glucose/diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complaints of muscle pain or weakness w/o elevation in creatine kinase (CK), marker for muscle damage

A

Myalgia

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

Complaints of muscle aches/pains w/ mildly elevated CK levels (<10 times the ULN)

A

Myositis

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

Complaints of muscle pain w/ presence of dark urine and a CK level > 10 times the ULN

A

Rhabdomyolysis

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

Drug interactions of Statins: potentiate the risk of myopathy/rhabdomyolysis

A
  • Amidarone
  • Azole antifungal agents
  • Macrolide antibiotics
  • Verapamil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cholestyramine

A

Bile acid sequestrant

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

Colesevelam (Welchol)

A

Bile acid sequestrant

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

Cholestyramine and Colesevalam/Wilchol are both indicated for

A

Hypercholesteremia

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

Indicated for diarrhea and pruritis associated w/ partial biliary obstruction.

A

Cholestyramine

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

Indicated to improve glycemic control in adults w/ Type II diabetes mellitus

A

Colesevelam (Welchol)

18
Q

interrupts the enterohepatic circulation of bile acids which depletes cholesterol content of hepatic cells

A

Bile acid sequestrants MOA

19
Q

Bile acid sequestrant: adverse effects

A
  • constipation
  • abdominal pain
  • bloating
  • dyspepsia (indigestion)
  • flatulence
  • INCREASES TG (TG>400 mg/dL contraindicated)
20
Q

Bile acid sequestrant: drug ineractions

What do these drugs decrease the absorption of?

A
  • warfarin
  • levothyroxine
  • digoxin
  • thiazide diuretics
21
Q

When should other medications be taken when taken bile acid sequestrants?

A

other medications should be taken at least 1 hour before or 4 hours after the bile sequestrant

22
Q

Inhibits intestinal absorption of dietary and biliary cholesterol at the brush border of the small intestine

23
Q

Ezetemibe: adverse effects

A
  • GI: diarrhea, abdominal pain

- increase in ATL

24
Q

Gemfibrozil

25
Fenofibrate
Fibrate
26
Fibrates: adverse effects
- abdominal pain, INCREASE IN GALLSTONES - MYALGIA, MYOPATHY - increase in serum creatinine
27
Activates peroxisome proliferator activator - alpha (PRAR-alpha) which enhances catabolism (by LIPOPROTEIN LIPASE) of triglycerides and decrease hepatic synthesis of VLDL particles and increases HDL levels
Fibrates MOA
28
Fibrates contraindications
- severe hepatic disease - SEVERE RENAL DISEASE (DO NOT USE FENOFIBRATE) - PREEXSITING GALLBLADDER DISEASE
29
Gemfibrozil drug interaction
- CONTRAINDICATED: INCREASES REPAGLINIDE LEVELS (HYPERGLYCEMIA) - increases statin levels (muscle toxicity)
30
Fenofibrate drug interaction
has minimal impact on statin levels
31
Enhance lipoprotein lipase
Niacin MOA
32
Niacin adverse effects
- GI (nausea, exacerbation of peptic ulcers) - flushing, pruritus - liver dysfunction (liver enzyme abnormalities) - glucose intolerance (hyperglycemia) - hyperuricemia/gout - peptic ulcer disease
33
Niacin contradindications
- significant hepatic dysfunction - active peptic ulcer disease - gout
34
Indicated to treat hypertriglyceridemia > 500 mg/dL
Omega-3-acid ethyl esters
35
Indicated for high TG (> or equal to 500 mg/dL)
Icosapent ethyl
36
Icosapent ethyl
may prolong bleeding time
37
What should you monitor when giving Icosapent ethyl?
LFT (patients w/ hepatic impairment), lipids
38
Moderate risk: 2+ riskfactors | 10-year risk < 10%
LDL goal: < 130 | non-HDL goal: <160
39
High risk: CHD or CHDrisk equivalents | 10-year risk >20
LDL goal: <160
40
Moderate high risk: 2+ risk equivalents | 10-year risk 10%-20%
LDL goal: <160
41
Use caution in patients w/ known hypersensitivity to fish and/or shellfish
Icosapent ethyl
42
What do omega-3 ethyl esters contain that icosapent ethyl doesn't? And what does it cause?
- contains DHA | - causes an increase in LDL