Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Spring 22 PT HTN > Ndefo CHOLESTEROL > Flashcards

Ndefo CHOLESTEROL Flashcards

(61 cards)

Start Studying
1
Q

VLDL is another indicator of

A

artherogenic cholesterol

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

High-density lipoproteins (HDL) known as “good” cholesterol because it removes cholesterol from the walls of arteries and returns them to the

A

liver for disposal

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

Friedwald equation:

Does not work if TG >400 mg/dL

A

LDL = Total cholesterol – HDL – (TG/5)

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

Key risk factors for heart disease are

A

high blood pressure

high blood cholesterol

smoking

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

______ is a mediator of immune response and serves as marker of inflammation

A

C-Reactive Protein (CRP)

  • hs-CRP – is high sensitivity (more sensitive for CVD)
  • Low < 1; intermediate 1 – 3; high >3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Emerging Risk Factors

A 
C-Reactive Protein (CRP)
Lipoprotein(a)
Apolipoprotein-B
Coronary Artery Calcium
Ankle Brachial Index (ABI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lifestyle Modifications

A

Physical activity
-Engage in aerobic physical activity; 3-4 sessions per week; lasting ~ 40 minutes per session, involving moderate-to vigorous physical activity

Avoidance of tobacco products

Maintenance of a healthy weight

Adhering to a heart healthy diet

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

B&G:

Lovastatin

Lovastatin ER

Pravastatin

Simvastatin

Fluvastatin

Atorvastatin

Rosuvastatin

Pitavastatin

A

Mevacor

Altoprev

Pravachol

Zocor, FloLipid

Lescol

Lipitor

Crestor

Livalo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lovastatin (Mevacor®), Lovastatin ER (Altoprev®) dosing:

A

10, 20, 40 mg oral tablet; 20, 40, 60 mg ER oral tablet

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

Pravastatin (Pravachol®) dosing:

A

10, 20, 40, 80 mg oral tablet

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

Simvastatin (Zocor®, FloLipid®) dosing:

A

5, 10, 20, 40, 80 mg oral tablet

Oral suspension (FloLipid 20 mg/5 ml, 40 mg/5 ml)

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

Fluvastatin (Lescol®) dosing:

A

20, 40 mg oral capsule, 80 mg ER tablet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Atorvastatin (Lipitor®) dosing:

A

10, 20, 40, 80 mg oral tablet

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

Rosuvastatin (Crestor®) dosing:

A

5, 10, 20, 40 mg oral tablet

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

Pitavastatin (Livalo®)

A

1 , 2, 4 mg oral tablet (no generic)

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

Statin Equivalent Doses

A

Pharmacists Rock At Saving Lives and Preventing Fatty deposits

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

You should check ______________ at baseline in pt w. hepatic injuries

A

alanine aminotransferase (ALT) at baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you check for symptoms of hepatotoxicity?

A
  • Unusual fatigue
  • Loss of appetite
  • Abdominal pain
  • Dark colored urine
  • Yellowing of skin or sclera
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Statin-induced myopathy should be ___________ and in large adjacent muscle groups

A

SYMMETRICAL

  • Usually in legs, back, or arms
  • Usually occurs within 6 weeks of initiation but can happen at anytime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TorF: Coenzyme Q10 may provide benefit of mild myalgias

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

TorF: Pts should avoid gemfibrozil and statin combinations

A

True

Gemfibrozil(LOPID) with statins increase the risk for myopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should you do if a patient is experiencing severe unexplained muscle symptoms or fatigue during statin therapy??

A
  • Promptly discontinue the statin
  • Evaluate CK and creatinine
  • Check urinalysis for myoglobinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Common Statin Drug Interactions

A
  • G – Grapefruit
  • P – Protease inhibitors
  • A – Azole Antifungals
  • C – Cyclosporine, Cobistat
  • M – Macrolides (except azithromycin)
  • A – Amiodarone
  • N – Non-DHP CCBs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

TorF: Statins should be discontinued in patients with diabetes until adverse effects are realized.

A

False. Statin use should not be discontinued in patients with
diabetes, including newly diagnosed individuals due to no greater risk of MI, stroke or ASCVD without a statin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What FDA approved antidiabetic medications are used in the prevention of cardiovascular diseases?
• GLP-1 receptor agonist "The TIDES” - liraglutide (Victoza®) - dulaglutide(Trulicity®) - semaglutide (Ozempic®) • Sodium glucose cotransporter 2 inhibitor – empagliflozin(Jardiance®) -canagliflozin (Invokana®)
26
When starting a statin, what labs should you check?
8-12h NPO FLP ALT A1C if diabetes status is unknown Creatinine kinase when indicated Pregnancy
27
Repeat lipid measurements ________ weeks after statin therapy or dose changes
4-12 weeks
28
Define responses to lifestyle with statin therapy by PERCENTAGE REDUCTIONS in LDL-C compared with baseline
* High intensity ≥50% | * Low intensity 30 to < 50%
29
How do you counsel on statins?
* Take this medicine at the same time every day, preferably at night (lovastatin with evening meal) * Do not consume excessive quantities of grapefruit products * Do not miss any doctor or lab appointment • Report signs/symptoms of myopathy or rhabdomyolysis (muscle pain, tenderness, weakness, fever) * May cause diarrhea, UTIs, extremity pain, nasopharyngitis, arthralgia, dyspepsia, or nausea * Report signs and symptoms of liver injury (jaundice, dark urine, upper abdominal discomfort, anorexia, fatigue) * Avoid excessive quantities of alcohol to reduce risk of hepatotoxicity
30
What groups of people should absolutely be started on a statin?
Clinical ASCVD Severe Hypercholesterolemia Diabetes mellitus Primary Prevention
31
Severe Hypercholesterolemia is defined as between age 20-75 with LDL-C of _________
GREATER THAN or equal to ≥190 mg/dL
32
What are secondary causes of INCREASED LDL-C?
* Hypothyroidism * Nephrotic syndrome * Alcoholism * Smoking * Diabetes * Obstructive liver disease
33
Which drugs cause an increase in LDL-C?
Protease inhibitors * Steroids * Thiazide diuretics * Immunosuppressants (cyclosporine, tacrolimus) * Fibrates * SGLT2 inhibitors * Progestins * Isotretinoin (retinols)
34
THESE pts who have diabetes should absolutely be placed on a statin therapy:
Between the ages of 40-75 with LDL greater than 70 mg/dL OR If between ages 20-39, with diabetes-specific risk enhancers such as * Long duration (≥10 years for type 2; ≥20 years for type 1) * Albuminuria ≥30 mcg albumin/mg creatinine * eGFR <60 ml/min/1.73 m2 * Retinopathy * Neuropathy * Ankle Brachial Index <0.9 (measures blood flow to the arteries of the legs)
35
Risk-Enhancing Factors
• Family history of premature ASCVD • Persistently elevated LDL-C levels ≥160 mg/dL • Chronic kidney disease • History of preeclampsia or premature menopause • Chronic inflammatory disorders (rheumatoid arthritis, psoriasis, chronic HIV) • High risk ethnic groups (South Asian ancestry) • Persistent elevations of triglycerides ≥175 mg/dL - Metabolic syndrome
36
When statin therapy is not enough, and the patient triglyceride level is greater than 500 mg/dL what medication or pharmacological therapy should you use?
Use omega-3 fatty acids or fenofibrate
37
When is it appropriate to use non-statin therapy?
* Patients who cannot tolerate statins (statin intolerance) or can only tolerate less than recommended statin intensity * Patients who do not achieve the expected statin response and are high risk for ASCVD • Triglycerides >500 mg/dL -Use omega-3 fatty acids or fenofibrate
38
Bile acid sequestrants may be used in ezetimbe-intolerant | patients with TG _________
TG ≤ 300 mg/dL Normal: less than 150mg/dL
39
Vytorin generic & dosing
Ezetimibe and simvastatin 10/10, 10/20, 10/40, 10/80mg
40
Praluent
Alirocumab
41
Praluent is indicated for
- Familial hypercholesterolemia (in combination with a statin) - Primary hypercholesterolemia with atherosclerotic cardiovascular disease (in combination with a statin)
42
Repatha generic and indication
Evolocumab, * Familial hypercholesterolemia (in combination with other lipid lowering therapies) * Familial hypercholesterolemia (in combination with a statin) * Primary hypercholesterolemia with atherosclerotic cardiovascular disease (in combination with a statin)
43
Welchol
Colesevelam
44
Questran
Cholestyramine
45
Colestid
Colestipol
46
Bile acid sequestrants MOA
binds to bile acids in the gut and excretes them into the feces
47
TorF: BAS lower A1c but increase TGs
True
48
TorF: BAS have been proven to decrease LDL and ASCVD to the same level as statins
False. NOT TO THE SAME EXTENT
49
When are BAS contraindicated?
Contraindicated for fasting TG ≥300 mg/dL
50
Fibrates MOA
Peroxisome proliferator receptor alpha (PPARα) activator
51
Icosapent Ethyl
Vascepa
52
Omega-3 Acid Ethyl esters
Lovaza
53
Nexletol & MOA
Bempedoic acid * Adenosine triphosphate-citrate lyase (ACL) inhibitor, inhibits cholesterol synthesis in the liver * ACL - An enzyme upstream of HMG-CoA reductase in the cholesterol biosynthesis pathway
54
Inclisiran
Leqvio MOA – small interfering RNA therapy – directs catalytic breakdown of mRNA for PCSK9
55
Advicor
Lovastatin and Niacin Lovastatin and Niacin (Advicor ®): 20/500, 20/750, 20/1000, 40/1000 mg
56
Niacin
Decreases the rate of hepatic synthesis of VLDL and LDL No evidence of reduced coronary events Contraindicated in peptic ulcer disease
57
Nexlizet
Zetia and Nexletol
58
Psyllium
Psyllium (Metamucil) * Temporarily aids in LDL reduction * 10 – 15 gm/day * Can use in conjunction with bile acid sequestrants to ease constipation
59
Juxtapid
Lomitapide
60
Evkeeza
Evinacumab Angiopoietin-like protein 3 (ANGPTL3) inhibitor (ANGPTL3 regulates lipid metabolism) Approved for the treatment of Homozygous Familial Hypercholesterolemia (orphan drug) in 12+
61
Fetal risk is minimal with _________ and ____________
Fetal risk is minimal with bile-acid sequestrants and omega-3 fatty acids Fetal risk cannot be ruled out with niacin, fenofibrate and gemfibrozil

Spring 22 PT HTN (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions