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Flashcards in Pharm: Hyperlipidemia Deck (19)
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1

4 leading conditions associated with secondary (acquired) dyslipidemia

1. Diabetes Mellitus (both types)
2. HYPOthyroidism
3. Cholestatic Liver Disease
4. Nephrotic Syndrome

2

What HDL level measured on lipid panel can act as a negative risk factor for high cholesterol?

>60 mg/dL

3

What are 4 Pleiotropic (when 1 thing has an influence on multiple other things) effects of statin therapy in people with high cholesterol?

1. Decreased Inflammation
2. Decreased endothelial dysfunction
3. Decreased Thrombus formation
4. More stable atherosclerotic plaque

4

What are the desireable or optimal levels for: Total cholesterol, LDL, HDL, and TGs according to the ATP (Association of Tennis Professionals) III classification.

Adult Treatment Panel (ATP)
Total < 200
LDL < 100
HDL > 60
TGs <150

5

Mechanism of Statins

Inhibit HMG-CoA reductase inhibiting endogenous cholesterol production.

6

Which 3 statins are the most effective at lowering HDL?

Pitavastatin
Rosuvastatin
Atorvastatin

7

What levels of total cholesterol, LDL, HDL, and TGs are considered high cholesterol according to the ATP III classification?

Total > 240 mg/dL
LDL > 160
HDL < 40
TGs >200

8

Fenofibrate

MOA: fibric acid derivative that increases LPL and Apo E production to lower TGs, LDL, raises HDL.

Use: Type III hyperlipidemia

Contraindications: caution with statins, gallbladder, hepatic, or renal disease

9

Gemfibrozil

MOA: fibric acid derivative that increases LPL and Apo E production to lower TGs, raises HDL. (less effective at lowering LDL so Fenofibrate is better)

Use: Type III hyperlipidemia

Contraindications: caution with statins, gallbladder, hepatic, or renal disease

10

Lovaza

MOA: omega-3-acid ethyl ester that inhibits liver cholesterol production. Supplement approved to lower TGs and raise HDL.

Simlar to Omega 3 fish oil.

11

Ezetimibe (Zetia)

MOA: Inhibits NPC1L1 lipid transporter to prevent absorption of cholesterol at the small intestine brush border.

Use: mainly decreases LDL, moderate increase in HDL

12

Colestipol

MOA: bile acid binding resin preventing reabsorption of bile salts

Use: high cholesterol in combination with niacin.

Adverse Effects: constipation, bloating

Containdications: familial hypercholesterolemia (no functioning LDL receptors).

13

Cholestyramine

MOA: bile acid binding resin preventing reabsorption of bile salts

Use: high cholesterol in combination with niacin.

Adverse Effects: constipation, bloating

Containdications: familial hypercholesterolemia (no functioning LDL receptors).

14

Colesevelam

MOA: bile acid binding resin preventing reabsorption of bile salts

Use: high cholesterol in combination with niacin.

Adverse Effects: constipation, bloating

Containdications: familial hypercholesterolemia (no functioning LDL receptors).

15

Niacin/Nicotinic Acid

MOA: Raises HDL, moderately lowers LDL

Use: high cholesterol, Gout (combined with allopurinol)

Adverse Effects: acanthosa nigrans, skin flushing

16

Coenzyme Q10

MOA: component of the electron transport chain that is made from cholesterol

Use: prevent mitochondrial dysfunction when using statins

17

How does Garlic help with high cholesterol?

Inhibits HMG-CoA reductase
Antiplatelet activity
Enhanced fibrinolytic activity
Antioxidant properties

18

Psyllium

MOA: bulk stool forming laxative, prevents reabsorption of components from feces including cholesterol

19

What are the:
Goal Levels
Therapeutic Lifestyle Change Levels
Drug therapy levels

recommended by ATP III regarding high cholesterol. High risk, moderately high, moderate,low.

High:
Goal 100
DT > 100

Moderately High
Goal < 130
TLC > 130
DT > 130

Moderate
Goal < 130
TLC > 130
DT > 160

Low
Goal < 160
TLC > 160
DT > 190