Some Heart and Some Blood Things Flashcards
(196 cards)
A TG level above ______ can cause acute pancreatitis
500
Please name 6 drugs that increase LDL and TG:
Diuretics
Efavirenz
Steroids
Immunosuppressants
Atypical Antipsychotics
Protease Inhibitors
What dyslipidemia drug is known to slightly elevate LDL?
Fish Oils
Name 3 drugs that increase TG only
Propofol
IV lipid emulsion
Bile Acid Sequestrates
Friedewald Equation
LDL = TC - HDL - TG/ 5
What are intensity does a diabetic patient that is 42 and an LDL of 120 require?
Moderate intensity!
Diabetic patient: 40 - 75
LDL: 70 - 189
With no ASCVD risk factors
What are intensity does a diabetic patient that is 42 and an LDL of 120 with ASCVD risk factors require?
High Intensity!
Diabetic patient: 40 - 75
LDL: 70 - 189
With ASCVD risk factors
A patient that is between 40 - 75 with an LDL between 70 - 189 and ASCVD risk score between 7.5 - 19.9% requires a…
Moderate intensity
Name the two high intensity statins and their doses
Atorvastatin 40 - 80
Rosuvastatin 20 - 40
What is the Pitavastatin Moderate intensity dose range?
2- 4 mg
Low: 1 mg
What is Simvastatins Moderate intensity dose range?
20 - 40 mg
Low: 10 mg
What is the moderate intensity dose range for pravastatin?
40 - 80 mg
Low: 10 - 20 mg
What is the moderate intensity dose range for Lovastatin?
40 mg
Low: 20 mg
What is the moderate intensity dose range for Fluvastatin?
40 mg BID / 80 QD XL
Low: 20 - 40
How do we reduce the risk of statin based Myalgia?
Avoid DDI
Do not exceed simvastatin 80 mg/d
Do not use gemfibrozil with a statin
How to manage Myalgia from a statin?
Hold, Check CPK
After 2 - 4 weeks rechallenge with the same statin or decrease the dose.
If myalgia returns d/c statin. Once muscle sx’s resolve a low dose statin can be started with a gradual increase
What statins can be taken at any time of day? (5)
Crestor
Lipitor
Livalo
Lescol XL
Pravachol
What are the lipid effects of statins?
Decrease LDL by 20 - 55%
Increase HDL by 5 - 15%
Decrease TG by 10 - 30 %
What are the significant DDI with Statins?
G <3 PACMAN
G: grapefruit
P: Protease inhibitors
A: Azoles
C: Cyclosporine
M: Macrolides (except Zpak )
A: Amio
N: Non DHP CCB
Do not use Simvastatin or Lovastatin in G - M
Statins MOA:
inhibit HMG CoA reductase. Rate limiting step in cholesterol synthesis
Ezetimibe MOA:
inhibits absorption of cholesterol in the small intestine
MOA of PCSK 9 Inhibitors:
PCSK9 = enzyme that increases LDL receptor degradation
the Inhibitors at MAbs that block the ability of PCSK 9 to bind to the LDL receptor.
(dramatic decrease in LDL)
Alirocumab
Praluent - SC
- HeFH or ASCVD
- PCSK9 - I
Evolocumab
Repatha - SC
*HeFH or ASCVD
* HoFH