Flashcards in Lecture 4.5 Lipid drugs (from Pharm exam) Deck (21):
what drug class causes the largest drop in TG's? what about LDL? What drug class increases HDL the most?
fibrates; statins; niacin
statins (competitively or non-competitively) inhibit ______. they also upregulate _____
competitively inhibit HMG CoA reductase;LDL receptors = reduces plasma chol
statins are indicated in patients with high _____ or those that have had an _____
LDL, acute MI
reduce LDL by 20-60%
short half-life statins should be taken in the _____.
evening (to inhibit nocturnal synthesis)
what is the most common side effect of statins? how do you follow this?what is another important side effect?
rhadomyolysis/myopathy, follow with CPK;
hepatotoxicity (Follow LFTs)
mechanism of action of bile acid resins:
prevent intestinal reabsorption of bile acids by forming insoluble complexes with them;upregulate LDL receptors
name 3 bile acid resins
cholestyamine, colestipol, colesevelam
bile acid resins primary effect on lipoproteins:
decrease LDL (by 20%); slightly increase HDL
side effects of bile acid resins (2)
GI upset, decreased absorption fat soluble vitamins/drugs ie statins
what drug inhibits small intestinal absorption of cholesterol?
ezetimibe primarily reduces ____;
rarely causes liver/muscle damage
alirocumab and evolocumab both inhibit ____.
what does PCSK9 usually do?
promotes degradation of LDL receptors
fibrates activate ____ to upregulate ____ and induce ____ synthesis
PPAR alpha; Lipoprotein lipase, HDL
hit me with 2 fibrates:
others exist as well
fibrates are especially indicated in patients with ____ in which VLDLs predominate
2 side effects of fibrates
myopathy (watch with statins);gall stones
what dietary supplement can reduce TG synthesis?
omega 3 FA (Fish oil/lovaza)
niacin is thought to increase ____ activity and decrease _____ production. niacin ____ hormone synthesis lipase in adipose tissue
lipase (increases VLDL clearance);
VLDL (in liver);
most common side effect of niacin:
how to help treat this?
cutaneous vasodilation, warmth;
use NSAIDs (inhibits PG release)