Hyperlipidemia Flashcards Preview

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Flashcards in Hyperlipidemia Deck (42):
1

rate limiting enzyme for intracellular cholesterol biosynthesis

HMG-CoA reductase

2

familial hypercholesterolemia

increased LDL

3

familial hypertriglyceridemia

increased TG

4

familial combined hyperlipidemia

increased LDL
increased TG

5

hypoalphalipoproteinemia

isolated HDL < 35

6

drugs that later lipid profiles

thiazide diuretics (increase TG)
BB (increase TG, decrease HDL)
OCP (increase cholesterol, increase TG)

7

optimal LDL C

<100

8

HDL-C

60 high

9

TC

<200 desirable

10

TG

<150 normal

11

Major CHD risk factors

LDL
cigarette smoking
HTN
low HDL (high HDL negates a RF)
Fhx premature CHD
Age

12

always use antihyperlipidemic drugs in conjunction with

diet, exercise, weight reduction

13

inhibits mobilization of FFA's from adipose tissue, results in decreased VLDL

niacin

14

best med choice to increase HDL. used in hyperlipoproteinemias, and as an adjunct to decrease TG

niacin

15

adverse effects: vasodilation, nausea, dyspepsia, activation of PUD, hyperuricemia, worsen glucose tolerance, hepatotoxicity (LFTs 3X normal!)

niacin

16

monitor glucose, uric acid, LFTs

niacin

17

contraindicated in DM, gout, peptic ulcer and LIVER DISEASE

niacin

18

drug interactions: hypotension with BP lowering drugs, DM meds- hyperglycemia, and increased risk or hepatotox with statins

niacin

19

inhibit lipolysis and increase lipoprotein lipase, decreasing serum VLDL and increasing HDL

fibrates

20

decrease TG, increase HDL, may increase LDL

fibrates

21

med of choice for lowering TG. also used for combined increased cholesterol and TG

fibrates

22

adverse effects include GI, myopathy, hepatotoxicity, neutropenia, gallstones, and pancreatitis

fibrates

23

this class inhibits enterohepatic recycling or bile acids and salts- causing the liver to convert stored cholesterol to bile acids

bile acid resins

24

reduces TC, LDL (dose dependent), increases HDL and TG

bile acid resins

25

adverse effects are mostly GI- constipation, bloating, gas, nausea. Avoid in pts with diverticulitis, swallowing difficulties, motility disorders

bile acid resins

26

ADRs with warfarin, thyroid, digoxin- separate ALL meds by at least 2 hours

bile acid resins

27

contraindicated in biliary obstruction, TG >500, or TG>200 (relative)

bile acid resins

28

competitively inhibit HMG-CoA reductase (necessary for cholesterol synthesis-results in an increase in hepatic LDL receptors)

statins

29

decreases LDL, decrease TG, increase HDL. Proven efficacy to reduce major coronary events and stroke, CV related and total mortality, and coronary procedures

statins

30

pleiotropic effects: CV (stabilize plaques, enhance NO production, decrease oxidative stress), renal (modulate inflammation), endocrine (improve insulin sensitivity), and skeletal (inhibit bone resorption)

statins

31

this class has few adverse effects. Most common are HA, myalgia, and dyspepsia. Hepatotoxicity and myopathy can occur

statins

32

reacts with CYP450 3A4 inhibitors- cyclosporine, grapefruit juice, macrolides, triazole antifungals, fluoroquinolones, SSRIs, diltiazem, verapamil, amiodarone, omperazole, protease inh

statins

33

statins not metabolized by 3A4

prava, fluva, rosuva

34

this statin increased warfarin effects

lovastatin

35

monitor AST/ALT, CK

statins

36

caution in liver and renal disease, contra in pregnancy

statins

37

combo niacin ER/ lovastatin- increases risk of myopathy. Monitor LFTs

advicor

38

inhibits absorption of cholesterol at the brush border of the SI, causing a decrease in delivery of cholesterol to the liver

ezetimbe

39

this drug may increase risk of AST/ALT elevation when used in combo with statins

ezetimbe

40

ADRs include GI, HA< arthralgia, sinusitis

ezetimbe

41

if LDL >205 above goal or patient is high/moderately high risk, what is our DOC

statins

42

if TG >500, use these drugs to reduce risk of pancreatitis

fibrate or niacin