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CDVD > Hyperlipidaemia > Flashcards

Hyperlipidaemia Flashcards

1
Q

What are the healthy levels of total cholesterol?

A

5 or below

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2
Q

What are the healthy levels of HDL (good)?

A

1 or above

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3
Q

What are the healthy levels of LDL (bad)?

A

3 or below

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4
Q

What are the healthy levels of non-HDL (bad)?

A

4 or below

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5
Q

What are the healthy levels of triglycerides?

A

2.3 or below

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6
Q

who should lipid lowering agents be offered to?

A
  • pt < 85yr with 10yr risk of CVD > 10%
  • pt TY2D with 10yr risk of CVD >10%
  • all TY1D = 40+, 10yr of diabetes, established nephropathy
  • pt with CKD
  • familial hypercholesterolaemia

- familial hypercholesterolaemia = genetic condiition where liver cannot

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7
Q

examples of statins

A

atorvastatin
rosuvastatin
simvastatin
fluvastatin
pravastatin

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8
Q

when should statins be taken and why

A

at night as there is high production of cholesterol at night but atorvastatin and rovostatin anytime

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9
Q

what strength of atorvastatin is strongest for secondary prevention?

A

80mg

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10
Q

which condition should be managed with statins

A

hypothyroidism

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11
Q

what should pt at high risk of diabetes check before starting statins

A

-fasting blood concentration or HbA1C
-repeat after 3 months

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12
Q

before initiation monitoring/tests of statins

A

full lipid
thyroid function
renal function
liver function

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13
Q

liver function monitoring with statins

A

-liver enzymes monitored before tx * every 3 months * every 12 months
-STOP if serum transaminase are higher than 3x upper limit

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14
Q

creatinine kinase monitoring with statins

A

-measured in pt who previously had persistent muscle aches
-if measurement 5x higher than upper limit remeasure in 7DY
->if still higher do not initiate statins
->if lvls are high but under 5x limit start statins at low dose*

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15
Q

s/e of statins

A
  • myopathy and rhabdomyolysis
  • interstitial lung disease
  • teratogenic x gv in pregn (x give 3MT before conceiving)
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16
Q

myopathy and rhabdomyolysis symptoms
(s/e of statin)

A

muscle toxicity = give medical if experiencing msucle symptoms including pain, tenderness, weakness

17
Q

interstitial lung disease symptoms
(s/e of statin)

A

give medical advice if experiencing dyspnoea, cough, weight loss

18
Q

teratogenic
(s/e of statin)

A

-Don’t give in pregnancy
-Don’t give 3 months before conceiving

19
Q

statins interactions

A
  • cyp450 inducers
  • cyp450 inhibitors
  • fusidic acid (oral)
20
Q

CYP450 inducers (statin interaction)

A

lower concentration of statins

21
Q

CYP450 inhibitors
(interaction of statin)

A

-increases concentration of statins which inc risk of rhabdomyolysis
- pt who are taking macrolides should stop statin during tx
- avoid grapefruit juice

22
Q

can you take statins with oral fusidic acid?
(statin interaction)

A

no STOP statins and restart after 7DY last dose

23
Q

max dose of amiodarone and simvastatin

A

20mg

24
Q

max dose of amlodipine and simvastatin

A

20mg

25
Q

max dose of dilitazem/verapamil and simvastatin

A

20mg

26
Q

max dose of ticagrelor and simvastatin

A

40mg

27
Q

max dose of ciclosporin and atorvastatin

A

10mg

28
Q

max dose of tipranavir and atorvastatin

A

10mg

29
Q

what are the other lipid lowering drugs

A

-ezetimibe
-fibrates

30
Q

ezetimble interaction

A
  • ezetimibe + statins increase rhabomyolysis
31
Q

examples of fibrates

A

aprofibrates, fenofibrates, gemfibozil

32
Q

s/e of fibrates

A

-lowers lipid profile
-myotoxicity in renal impairment

33
Q

monitoring of fibrates

A

LFT every 3 months for first year

34
Q

interaction of fibrates

A

statin + fibrates = increased risk of muscle related s/e

CDVD (10 decks)

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