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57 Cards in this Set

  • Front
  • Back
antihyperlipidemics decrease the concentration of circulating what?
lipoproteins, in order of increasing density
1) chylomicrons
3) IDL
4) LDL
5) HDL
chylomicrons are transport form of?
GI absorbed triglycerids
chylomicrons rapidly removed from circulation into?
1) adipose tissue and
2) skeletal muscle
What does muscle use as energy source?
Which one is the least dense lipoproteins?
VLDL is synthesized in?
the liver
VLDL is transporter of?
lipids to peripheral tissues
IDL (intermediate density lipoproteins)
1) liver synthesis
2) lipid transporter
LDL (low density lipoproteins)
1) liver synthesis
2) "BAD" lipoprotein
LDL is major transporter of?
cholesterol (liver to peripheral)
HDL (high density lipoproteins)
1) liver synthesis
2) "GOOD" lipoproteins
HDL transport cholesterol from?
from tissue to liver
Does human body make own cholesterol?
Yes. Liver synthesize it.
high concentration of LDL's lead to increased risk of?
atherosclerotic plaques develop with the addition of?
1) cholesterol
3) collagen
4) fibrin
what is used to synthesize cholesterol?
% of hyperlipidemia in population
15 - 20 %
hyperlipidemia is belived tied to?
1) obesity
2) poor diet (high fat and carbohydrates)
risk factors of lyperlipidemia?
1) genetics
2) poor diet
3) smoking
4) excessive alcohol consumption
5) sedentary lifestyle
primary goal for hyperlipidemia is?
to lower LDL and triglycerides while increasing HDL/LDL ratio
what are the first line of therapy?
1) diet modification and
2) exercise plan
what knid of diet decrease LDL and increase HDL?
diet rich in UNsaturated fats
1) bile acid binding resins
2) HMG-CoA reductase inhibitors (Statins)
3) Niacin (Nicotinic acid)
4) Clofibrate (Atromid-S)
5) Gemfibrozil (Lopid)
6) Ezetimibe (Zetia)
bile acid binding resins are recommended for use in pts with?
1) high LDL but
2) near normal TGC levels
bile acid binding resins
1) Cholestyramine (Questran)
2) Colestipol (Colestid)
3) Colesevelam (Welchol)
bile acid binding resins are:
water insoluble cation exchange resins
how does it work?
1) bind up released bile salts (and their attached cholesterol) in the GI
2) prevent their reabsorption
adverse effects of bile acid binding resins?
1) constipation
2) POOR COMPLIANCE (sand-like consistency)
3) abd. cramping
4) absorption of fat-soluble vitamins
5) bind with other drugs
what medications can not take together with bile acid binding resins?
1) Digitalis
2) beta blockers
Which one is the first-line therapeutic?
bile acid binding resins
HMG-CoA reductase inhibitors (Statins) inhibit?
the rate-limiting enzyme in cholesterol synthesis
name of the enzyme?
3-hydroxy-3-methylglutaryl coenzyme A reductase
HMG-CoA reductase inhibitors (Statins) block?
cholesterol synthesis (not dietary) and decrease LDL cholesterol
decreased LDL levels also stimulate the production of?
hepatic LDL receptors and thus further decreases the plasma LDL level
HMG-CoA reductase inhibitors
1) Lovastatin (Mevacor)
2) Atorvastin (Lipitor)
3) Fluvastatin (Lescol)
4) Pravastatin (Pravachol)
5) Simvastatin (Zocor)
6) Rosuvastatin (Crestor)
HMG-CoA reductase inhibitors act primarily in?
the liver to decrease the production of cholesterol
adverse effects of HMG-CoA reductase inhibitors
1) increase plasma aminotransferase levels
2) skeletal muscle weakness/pain
3) increase plasma creatine phosphokinase
4) rhabdomyolysis
5) renal failure
Niacin (Nicotinic acid)decreases?
both VLDL and LDL
Niacin inhibits?
free fatty acid release from adipose tissue
adverse effects of Niacin
1) hepatic damage
2) hyperglysemia
3) > plasma uric acid levels (gout)
4) potent vasodilator
5) flushing
6) headaches
7) syncope
8) abd. pain
9) diarrhea
10) skeletal muscle myopathy
Why the higher doses of Niacin is not tolerated?
too many side effects
main action of Clofibrate (Atromid-S)?
to reduce VLDL fraction
major SE of Clofibrate
cholelithiasis and cholecystitis
other SE of Clofibrate
1) arrythmias
2) intermittent claudication
3) thromboembolisms
Gemfibrozil (Lopid) is used to treat pts with?
increased TGC WITHOUT increased LDL cholesterol
mechanism of Gemfibrozil (Lopid): it stimulates?
lipoprotein lipases
Lipoprotein lipases?
break down TGC
avoid the use of Gemfibrozil with?
pts with history of heart disease due to possible arrythmia
adverse effects of Gemfibrozil?
1) gallstones
2) skeletal muscle myopathy
3) GI upset
Ezetimibe (Zetia) is an inhibitor of?
intestinal cholesterol transport
Is the mechanism of Ezetimibe similar with other agents?
It does not inhibit liver synthesis of cholesterol or increase biliary excretion
metabolism of Ezetimibe (Zetia)
via liver glucuronidation then excreted in urine
combination therapy
1) Gemfibrozil (Lopid) + ?
bile acid binding resins
2) Statin + ?
bile acid binding resins
3) Niacin + ?
bile acid binding resins
4) Ezetimibe (Zetia) + ?
Simvastatin (Zocar) = Vytorin