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Pharmacology Exam 2 > Hyperlipidemia > Flashcards

Hyperlipidemia Flashcards

1
Q

Optimal LDL

A

<100

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2
Q

Near optimal LDL

A

100 – 129

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3
Q

Borderline LDL

A

130 – 159

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4
Q

High LDL

A

160 – 189

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5
Q

Very high LDL

A

> 190

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6
Q

TGL Ideal

A

<150

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7
Q

Desirable total cholesterol

A

< 200

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8
Q

Borderline total cholesterol

A

200 – 239

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9
Q

High total cholesterol

A

> 240

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10
Q

Low HDL

A

<40

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11
Q

High HDL

A

> 60

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12
Q

Lipoprotein (a)

A

Modified form of LDL.
Impairs fibrinolysis, promotes deposition of cholesterol in arthrosclerotic plaques.
Routine screening not recommended.
Decrease with Niacin.

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13
Q

Homocysteine

A

Amino acid, has athrogenic and prothrombotic effects.
Routine screening not recommended.
Decrease with Folate, B6 & B12.

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14
Q

Clinical Atherosclerotic Cardiovascular Disease (ASCVD)

A

Age ≤ 75: high-intensity statin

Age > 75 OR not candidate for high-intensity statin: moderate-intensity statin

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15
Q

LDL-C ≥ 190 mg/dl

A

Evaluate for secondary causes of hyperlipidemia
High-intensity statin (moderate-intensity if not candidate for high-intensity statin)
May add non-statin if needed to further lower LDL-C

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16
Q

Age 40 – 75 with diabetes

A

Moderate intensity statin (high intensity if≥ 7.5% 10-yr ASCVD risk)
Weigh individual risks and benefits for older or younger patients

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17
Q

≥ 7.5% 10-year ASCVD risk and age 40 – 75

A

Moderate to high intensity statin

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18
Q

High Intensity Statin

A

Lowers LDL-C by >/= 50%

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19
Q

Moderate Intensity Statin

A

Lowers LDL-C by 30-50%

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20
Q

Low Intensity Statin

A

Lowers LDL-C by <30%

21
Q

Atorvastatin (Lipitor)

A

40-80 mg

High Intensity Statin

22
Q

Rosuvastatin (Crestor)

A

20-40 mg

High Intensity Statin

23
Q

Atorvastatin (Lipitor)

A

10-20 mg

Medium Intensity Statin

24
Q

Rosuvastatin (Crestor)

A

5-10 mg

Medium Intensity Statin

25
Simvastatin (Zocor)
20-40 mg Medium Intensity Statin NOT with itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, nefazodone, gemfibrozil, cyclosporine, danazol. NO more than 20 mg with amlodipine
26
Pravastatin (Pravachol)
40-80 mg | Medium Intensity Statin
27
Lovastatin (Mevacor)
40 mg | Medium Intensity Statin
28
Fluvastatin XL (Lescol XL)
80 mg | Medium Intensity Statin
29
Fluvastatin BID
40 mg | Medium Intensity Statin
30
Pitavastatin (Livalo)
2-4 mg | Medium Intensity Statin
31
Simvastatin (Zocor)
10 mg Low Intensity Statin NOT with itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, nefazodone, gemfibrozil, cyclosporine, danazol. NO more than 10 mg with amiodarone, verapamil, diltiazem.
32
Lovastatin (Mevacor)
20 mg | Low Intensity Statin
33
Fluvastatin BID
20-40 mg | Low Intensity Statin
34
Pitavastatin (Livalo)
1 mg | Low Intensity Statin
35
Statins are Pregnancy Category __
X
36
Before starting statin therapy and monitoring on statins
Baseline ALT Baseline CK for patients at increased risk for adverse muscle events Liver functions or CK during statin therapy for symptoms Evaluate for diabetes according to recommended screening Evaluate for other source of muscle pain if occurs Evaluate for other causes of confusion or memory impairment if occur
37
Hypertriglyceridemia
Recommend fibric acids first line Nicotinic acid or Omega-3 fatty acids next Avoid bile acid sequestrants (elevate TG)
38
HMG-CoA Reductase Inhibitors (Statins)
Block conversion of HMG-CoA to mevalonate, thereby limiting the rate of production of cholesterol in the liver. . Adverse effects: Myopathy, myalgias Increased liver enzymes Contraindicated with liver disease, caution with heavy alcohol use Drug interactions (CYP system)
39
Bile Acid Resins (Bile Acid Sequestrants)
Decreases return of cholesterol to liver by binding bile acids into an insoluble compound that is excreted in the feces. Increased LDL receptors on liver Decrease serum LDL, but will increase VLDL & triglyceride level. Best for moderated elevated LDL and low CVD risk Do not use if TG >200 – 400. May be given along with statins. GI side effects. Give other meds at least 1 hour before or 4 hours after Often used for women who are pregnant or who may become pregnant
40
Niacin (Nicotinic Acid)
Unknown MOA. Decreases VLDL synthesis in liver. Avoid in liver disease, PUD, arterial bleeding. Can increase glucose, PT, uric acid, Cn decrease phosphorus, platelets. Causes flushing and itching of the neck and face (325 mg of Aspirin 30 minutes before dose may help).
41
Cholesterol Absorption Inhibitors
Works on brush border of small intestine decreasing absorption of cholesterol and decreasing delivery to liver. Reduces stores in liver and increases clearance of cholesterol from the blood.
42
Fibric Acid Derivatives
Unclear MOA. Stimulation of lipoprotein lipase enhances breakdown of VLDL to LDL. May inhibit hepatic VLDL production. Effective triglyceride lowering drug. Modestly lower LDL. Raise HDL. Do not use with severe renal or .hepatic disease Watch for gallstones, myopathy Caution with anticoagulants (and fenofibrates). Gemfibrozil can NOT be added to a statin. GI side effect.
43
Omega-3 Fatty Acids
May reduce VLDL-TGL synthesis and/or secretion from liver. May enhance TGL clearance from circulating VLDL. Indicated for reduction of TG in adults with severe hypertriglyceridemia (>500 mg/dl). May elevate LDL. Monitor liver enzymes. Lovaza has warning about atrial fib/flutter. Can add to a statin.
44
Cholestyramine (Questran)
Bile Acid Resins (Bile Acid Sequestrants)
45
Cilesevelam (Welchol)
Bile Acid Resins (Bile Acid Sequestrants)
46
Colestipol (Colestid)
Bile Acid Resins (Bile Acid Sequestrants)
47
Ezetamide (Zetia)
Only Cholesterol Absorption Inhibitor on market
48
Fenofibrate (Tricor, Trilipix)
Fibric Acid Derivative
49
Gemfibrozil (Lopid)
Fibric Acid Derivative

Pharmacology Exam 2 (11 decks)

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