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35 Cards in this Set
- Front
- Back
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What are the acceptable level of serum lipid levels?
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cholesterol under 200
LDL under 160 in healthy ind. LDL under 140 with 2 risk factors LDL under 100 with CAD TAG under 150 |
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What is primary hyperlipidemia?
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it is due to genetic or dietary causes
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What is secondary hyperlipidemia?
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associated with drug or disease
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What is the first line of therapy in treating hyperlipidemia?
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Diet fat intake
Restrict alcohol and carb's in hypertriglyceridemia Exercise (increases HDLs) |
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What is the MOA of Cholestyramine, colesevelam, and colestipol?
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Bind bile acids and prevent GI absorption.
Increases lipid excretion in feces with bile acids Enhance conversion of cholesterol to bile acids Increased LDL receptors in liver |
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What are the therapeutic uses of bile acid resins (Cholestyramine, colesevelam)?
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Hypercholesterolemia
Peak effect in 4 weeks No effect on triglyceride levels |
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What are some adverse effects of cholestyramine and colesevelam?
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Constipation, bloating, abdominal pain - Must be taken with fluids
colesevelam - fewer GI side effects Useful in pregnancy Can cause fat soluble vitamin malabsorption (also lipid soluble drugs - VPA, digoxin, AB's, warfarin, hydrichlorothiazide) |
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What is the MOA of statin drugs?
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competitive inhibitor og HMG CoA reductase
increases liver LDL receptors |
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What are the usese of statin drugs?
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Lower cholesterol
and triglycerides iwith atorvastatin and rosuvastin |
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What are the adverse effects of statins?
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elevates serum transaminase
monitor ALT/AST muscle weakness, mylagia, dark brown urine |
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What are the contraindications for statin drugs?
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Pregnancy, nursing, liver disease
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What are some dosing concerns with statin drugs?
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time of day
all statins but Atorvastatin and rosuvastin have to be take IN THE EVENING |
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What statin is recommended in pediatric patients?
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pravastatin
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What is something to be aware of when taking the prodrug statins, Lovastatin and simvastatin?
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don't drink grapefruit juice or drugs that are metabolized by CYP 3A4
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What is the MOA of Ezetimibe?
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inhibits cholesterol absorption in the enterocytes of the SI
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What are the uses of ezetimibe?
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lowers cholesterol
better than high dose statin in lowering LDL C |
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What are the adverse effects of ezetimibe?
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do not use in hepatic insufficiency
diarrhea when used with statins, more likely to increase transaminase levels |
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What is the MOA of Gemfibrozil, Fenofibrate and clofibrate?
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decreases hepatic VLDL production
increases HDL increases lipoprotein lipase |
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What are the therapeutic uses of Gemfibrozil, fenofibrate, and clofibrate?
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hypertriglyceridemia
increasing HDL |
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What are the adverse effects of gemfibrozil and fenofibrate?
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galstones with clofibrate
myopathy when combined with statin |
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What are the contraindications of gemfibrozil, fenofibrate and clofibrate?
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gallbladder disease, liver disease, renal disease
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What ins the MOA of Niacin and Nicrotinic Acid?
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decreased triglyceride synthesis
diminish VLDL and LDL production Increase lipoprotein lipase activity |
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What are the therapeutic uses of niacin and nicotinic acid?
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lowers triglycerides
lowers cholesterol adds benefit to other hyperlipidemia drugs |
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What are the adverse effects associated with niacin and nicotinic acid?
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flushing
peptic ulcers hyperuricemia worse glucose intolerance elevate transaminase itching |
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What are the contraindications for niacin and nicotinic acid?
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active liver disease
peptic ulcers bleeding disorders |
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What is seen in Familial LPL deficency type 1? What is the suggested therapy?
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elevated chylomicrons after fast, high triglycerides, defect in LPL or Apo CII
Heart disease not common diet therapy is the only useful therapy drugs do not work |
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What is seen in Familial LPL deficency type 2a?
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elevated LDL, due to decreased clearance or deficiency of receptors
Major increase in heart disease |
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What is seen in Familial LPL deficency type 2b?
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Increased VLDL and LDL
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What is seen in dysbetalipoproteinemia?
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elevated cholesterol and triglyceride
increased chylomicrons Most sensitive to Fibrates |
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What is seen in Familial hypertriglyceridemia?
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Increased VLDL and chylomicrons
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What diseases are high cholesterol often seen?
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biliary disease, renal disease, diabetes mellitus, hypothyroidism
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What diseases are triglycerides often elevated in?
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diabetes, alcoholsm, renal disease
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What drug class do diabetics best respond to?
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statins
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What drugs are known to cause hyperlipidemia?
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thiazides, beta blockers, oral contraceptives
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What must be dont in patients where you have prescribed statins?
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monitor ALT and myalgia
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