Term
| 5 types of lipid lowering agents |
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Definition
1. HMG-CoA Reductase inhibitors (statins) 2. Bile Acid-Binding Resins 3. Nicotinic Acid 4. Fibric Acid Derivative 5. Cholesterol Absorption inhibitors |
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Term
| HMG-CoA reductase inhibitors |
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Definition
"statins" Atorvastatin lovastatin pravastatin fluvastatin simvastatin rosuvastatin |
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Term
| which statin is the most potent |
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Definition
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Term
| which statin is the least potent |
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Definition
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Term
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Definition
inhibits HMG-CoA reductase -> rate limiting enzyme in cholesterol synth |
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Term
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Definition
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Term
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Definition
lowers all cholesterols and tris EXCEPT HDL -> stays same or incr |
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Term
| when should statins be dosed |
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Definition
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Term
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Definition
liver probs mm probs (myalgia/rhabdo) renal probs in pts w/ pre-existing conditions |
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Term
| will homozygous for familial hypercholesterolemia who lack LDL receptors benefit from statin use? |
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Definition
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Term
| who should not use statins |
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Definition
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Term
| when should you d/c statins |
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Definition
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Term
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Definition
| itraconazole, erythro, cyclosporine |
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Term
| what should be avoided w/ statin use |
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Definition
grapefruit juice fibrates->incr risk mm damage |
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Term
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Definition
cholestyramine colestipol colesevelam |
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Term
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Definition
large polymer w/ Cl ion -> exchange w/ bile acid prevents bile acid resporption-> fall in intracellular cholesterol-> incr hepatic uptake of LDL-C (fall in plasma conc) |
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Term
| tx uses of bile acid resins |
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Definition
decr LDL used in pts who can't tolerate statins DOC for phenotypes IIa and IIb hyperlipidemia 2nd line |
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Term
| DOC for IIa and IIb hyperlipidemia |
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Definition
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Term
| which drug is used to relieve pruritis in pts w/ biliary obst |
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Definition
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Term
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Definition
oral, powder, waffer NOT ABSORBED NOT METABOLIZED |
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Term
| which is the safest of all lipid lowering drugs |
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Definition
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Term
| AE bile acid binding resins |
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Definition
GI: constipation, bloating, indigestion, N Rare: decr abs of fat-sol vitamins Rare: folic/ascorbic acid abs. red. |
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Term
| drug interactions of bile acid binding resins |
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Definition
LOTS -> form complexes thiazides dig warfarin tetracylines aspirin phenobarb statins |
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Term
| how do you prevent drug interactions w/ bile acid binding resins? |
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Definition
stagger dosages! 1-2 hrs before or 6 hrs after taking other drugs |
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Term
| Nicotinic acid (niacin) MOA |
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Definition
red. hepatic VLDL and LDL syth secondary to inhibiting fatty acid mobilization from adipose tissue inhibits tissue lipolysis reducing supply of FFA's that liver uses to synthesize TG's for incorporated into VLDL |
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Term
| tx uses of nicotinic acids |
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Definition
decr LDL and VLDL and incr in HDL pts w/ type IIa and IIb familial severe hypercholesterolemias |
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Term
| what is the best agent for raising plasma HDL levels |
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Definition
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Term
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Definition
oral nicotinic acid->nicotinamide->NAD |
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Term
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Definition
flushing (aspirin, meals, ER, low dose) GI liver injury glucose intolerance HYPERURICEMIA |
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Term
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Definition
liver dysfxn PUD hyperuricemia (gout) DM |
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Term
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Definition
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Term
| MOA fibric acid derivatives |
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Definition
activate lipoprotein lipase-> delivery TG's to adipose tissue interfere with VLDL synth is liver HDL incr secondary synth apoprotein of HDL and incr assembly of HDL |
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Term
what should be monitored in pts on fibric acid derivatives |
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Definition
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Term
| when/why should fibric acid derivatives be d/c |
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Definition
when lipids do not fall after 3mos |
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Term
| fibric acid derivatives are DOC for what |
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Definition
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Term
| tx uses of fibric acid derivatives |
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Definition
hyper TG incr low levels of HDL's |
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Term
| AE fibric acid derivatives |
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Definition
GI cholelithiasis MM: myositis (worse when w/ statin) erectile dysfxn malignancy |
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Term
| CI/interactions fibric acid derivatives |
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Definition
warfarin (competes w/ protein binding) incr. sulfonylureas |
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Term
| who should fibric acid derivatives NOT be used in |
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Definition
prego liver/kidney dz gall bladder dz |
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Term
| cholesterol absorption inhibitors |
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Definition
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Term
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Definition
| inhibits cholesterol absorption in intestines |
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Term
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Definition
mono tx w/ statin primary hypercholesterolemia |
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Term
| how is ezetimibe metabolized |
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Definition
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Term
| what should you monitor in a pt on ezetimibe |
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Definition
LFT's esp when combined w/ statin |
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Term
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Definition
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