Antihyperlipidemics Pharm 6/29/06

Front 1

antihyperlipidemics decrease the concentration of circulating what?

Back 1

lipoproteins

Front 2

lipoproteins, in order of increasing density

Back 2

1) chylomicrons
2) VLDL
3) IDL
4) LDL
5) HDL

Front 3

chylomicrons are transport form of?

Back 3

GI absorbed triglycerids

Front 4

chylomicrons rapidly removed from circulation into?

Back 4

1) adipose tissue and
2) skeletal muscle

Front 5

What does muscle use as energy source?

Back 5

triglycerides

Front 6

Which one is the least dense lipoproteins?

Back 6

chylomicrons

Front 7

VLDL is synthesized in?

Back 7

the liver

Front 8

VLDL is transporter of?

Back 8

lipids to peripheral tissues

Front 9

IDL (intermediate density lipoproteins)

Back 9

1) liver synthesis
2) lipid transporter

Front 10

LDL (low density lipoproteins)

Back 10

1) liver synthesis
2) "BAD" lipoprotein

Front 11

LDL is major transporter of?

Back 11

cholesterol (liver to peripheral)

Front 12

HDL (high density lipoproteins)

Back 12

1) liver synthesis
2) "GOOD" lipoproteins

Front 13

HDL transport cholesterol from?

Back 13

from tissue to liver

Front 14

Does human body make own cholesterol?

Back 14

Yes. Liver synthesize it.

Front 15

high concentration of LDL's lead to increased risk of?

Back 15

atherosclerosis

Front 16

atherosclerotic plaques develop with the addition of?

Back 16

1) cholesterol
2) CALCIUM
3) collagen
4) fibrin

Front 17

what is used to synthesize cholesterol?

Back 17

triglyceride

Front 18

% of hyperlipidemia in population

Back 18

15 - 20 %

Front 19

hyperlipidemia is belived tied to?

Back 19

1) obesity
2) poor diet (high fat and carbohydrates)

Front 20

risk factors of lyperlipidemia?

Back 20

1) genetics
2) poor diet
3) smoking
4) excessive alcohol consumption
5) sedentary lifestyle

Front 21

primary goal for hyperlipidemia is?

Back 21

to lower LDL and triglycerides while increasing HDL/LDL ratio

Front 22

what are the first line of therapy?

Back 22

1) diet modification and
2) exercise plan

Front 23

what knid of diet decrease LDL and increase HDL?

Back 23

diet rich in UNsaturated fats

Front 24

antihyperlipidemics

Back 24

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)

Front 25

bile acid binding resins are recommended for use in pts with?

Back 25

1) high LDL but
2) near normal TGC levels

Front 26

bile acid binding resins

Back 26

1) Cholestyramine (Questran)
2) Colestipol (Colestid)
3) Colesevelam (Welchol)

Front 27

bile acid binding resins are:

Back 27

water insoluble cation exchange resins

Front 28

how does it work?

Back 28

1) bind up released bile salts (and their attached cholesterol) in the GI
2) prevent their reabsorption

Front 29

adverse effects of bile acid binding resins?

Back 29

1) constipation
2) POOR COMPLIANCE (sand-like consistency)
3) abd. cramping
4) absorption of fat-soluble vitamins
5) bind with other drugs

Front 30

what medications can not take together with bile acid binding resins?

Back 30

1) Digitalis
2) beta blockers

Front 31

Which one is the first-line therapeutic?

Back 31

bile acid binding resins

Front 32

HMG-CoA reductase inhibitors (Statins) inhibit?

Back 32

the rate-limiting enzyme in cholesterol synthesis

Front 33

name of the enzyme?

Back 33

3-hydroxy-3-methylglutaryl coenzyme A reductase

Front 34

HMG-CoA reductase inhibitors (Statins) block?

Back 34

cholesterol synthesis (not dietary) and decrease LDL cholesterol

Front 35

decreased LDL levels also stimulate the production of?

Back 35

hepatic LDL receptors and thus further decreases the plasma LDL level

Front 36

HMG-CoA reductase inhibitors

Back 36

1) Lovastatin (Mevacor)
2) Atorvastin (Lipitor)
3) Fluvastatin (Lescol)
4) Pravastatin (Pravachol)
5) Simvastatin (Zocor)
6) Rosuvastatin (Crestor)

Front 37

HMG-CoA reductase inhibitors act primarily in?

Back 37

the liver to decrease the production of cholesterol

Front 38

adverse effects of HMG-CoA reductase inhibitors

Back 38

1) increase plasma aminotransferase levels
2) skeletal muscle weakness/pain
3) increase plasma creatine phosphokinase
4) rhabdomyolysis
5) renal failure

Front 39

Niacin (Nicotinic acid)decreases?

Back 39

both VLDL and LDL

Front 40

Niacin inhibits?

Back 40

free fatty acid release from adipose tissue

Front 41

adverse effects of Niacin

Back 41

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

Front 42

Why the higher doses of Niacin is not tolerated?

Back 42

too many side effects

Front 43

main action of Clofibrate (Atromid-S)?

Back 43

to reduce VLDL fraction

Front 44

major SE of Clofibrate

Back 44

cholelithiasis and cholecystitis

Front 45

other SE of Clofibrate

Back 45

1) arrythmias
2) intermittent claudication
3) thromboembolisms

Front 46

Gemfibrozil (Lopid) is used to treat pts with?

Back 46

increased TGC WITHOUT increased LDL cholesterol

Front 47

mechanism of Gemfibrozil (Lopid): it stimulates?

Back 47

lipoprotein lipases

Front 48

Lipoprotein lipases?

Back 48

break down TGC

Front 49

avoid the use of Gemfibrozil with?

Back 49

pts with history of heart disease due to possible arrythmia

Front 50

adverse effects of Gemfibrozil?

Back 50

1) gallstones
2) skeletal muscle myopathy
3) GI upset
4) ARRYTHMIAS

Front 51

Ezetimibe (Zetia) is an inhibitor of?

Back 51

intestinal cholesterol transport

Front 52

Is the mechanism of Ezetimibe similar with other agents?

Back 52

No!
It does not inhibit liver synthesis of cholesterol or increase biliary excretion

Front 53

metabolism of Ezetimibe (Zetia)

Back 53

via liver glucuronidation then excreted in urine

Front 54

combination therapy
1) Gemfibrozil (Lopid) + ?

Back 54

bile acid binding resins

Front 55

2) Statin + ?

Back 55

bile acid binding resins

Front 56

3) Niacin + ?

Back 56

bile acid binding resins

Front 57

4) Ezetimibe (Zetia) + ?

Back 57

Simvastatin (Zocar) = Vytorin