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39 Cards in this Set

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This apoprotein enable VLDL and LDL to bind to vessel walls
B-100
Chylomicron's contain this unique apopprotein
B-48
HDL does not contain what apoprotein which limits its ability to bind to vessel walls
B-100
6 Statins
Atorastatin
Simvastatin
Pravastatin
Rosuvastatin
Flubastatin
Lovastatin
Method of acting for Statins
competitive inhibit of HMG-CoA Reductase Inhibitors

decreas cholesterol synth and increases LDL-receptors
When statins should be taken
At night b/c this is the time of highest cholesterol synthesis
Main uses of statins
Lower LDL

Smaller incrases in HDL and decreass in TG
Side Effects of statins
Myopathy (rabdomyolysis)
increased with higher doses and combination of niacina and fibrates
Asymptomatic increase in liver enzymes
Contraindications for statins
active or chronic liver disease
3 bile sequestrants
cholestyramine
colestipol
colsevelam
Method of action for cholestyramine, colestipol and colsevelam
Bind bile acids and prevent their recirculation. Failure to reabsorp bile acids causes shunting of cholesterol to the producting of new bile salts
Net effect of bilesquestrants
reduces LDL

some increase in HDL
Side Effects of cholestyramine, colestipol and colsevelam
GI effects secondary to reduced fat absorption

Lower vitamin ADEK uptake

Interactions with CHF meds
Bile sequestrants interactions
Digoxin, Coumadin, Thiazides, beta blocker and thyroxine

Give them 1 hour before or 4 hours after bile sequestrant
Contraindications of bile sequestrant
Can cause dangerous increases in TG's if patients with already eleveated TG's.

High TG's cause pancreatitis

Do not give if TG>400
Effects of Niacin
lower TG
Lower LDL
Raise HDL
Method of action of niacin
decrease VLDL synthesis
secondary increases in HDL synth and lowered HDL removal
Side effects of niacin
Flushing and skin issues
GI distress
arryhtmia, hyperuricemia, glucose intolerance and lazy eye
contraindications of niacin
liver disease
gout
diabetes
peptic ulcer disease
3 fibrates
Gemfibrozil
Fenofibrate
Clofibrate
Main effects of fibrates
lower TGs
raise HDL
Side effects of fibrates
myopathy
gallstones
dyspepsia
contraindications for fibrates
pregnant or nusing women
renal disease
hepatic disease
method of action for fibrates
increase oxidation of fatty acids
increases lipoprotein lipase (removal of TGs from VLDL's)

net effects if to lower TG's and shift depleted VLDLs to HDLs
Ezetimbie
Blocks cholesterol absorption from the gut

loweres plasma LDL

Combined with statins
gemfibrozil drug interactions
inhibits glucouranidation of statins, increasing statin side effects
This bile sequestrant only needs to be taking twice daily
Colsevelam
A patient has just taking some of his heart medication (digoxin, coumadin and thiazides). Which lipid drug must he now wait 4 hours to take
Colestyramine
Colestipol
Colsevelam
Before prescribing this drug, you must check the patients TG levels
Colestyramine
Colestipol
Colsevelam
You must check these levels before prescribing bile sequestrants
Triglycerides > 400 is absolute contraindication
Contraindicated in patients with severe gout
Niacin
Potential complication of this medicine in diabetic patient
Niacin
causes hyperglycemia
Excellent for lowering TG levels
Fibrates
Gemfibrozil
Fenofibrate
This drug increases the likelihood of myopathy in patients taking statins
Gemfibrozil

Inhibits glucouranidation of statins
If a patient is on this statin, its is safe to take gemfibrozil
Pravastatin

It is not metabolized by P450
Recommended in CAD patients with primarily low HDL
fenofibrate
Your hyperlipidemia patient becomes pregrant. She should be taken off of this drug
Gemfibrozil
Fenofibrate
Patients with severe renal disease should not take these drugs
Gemfibrozil
Fenofibrate
Patients with peptic ulcer disease should note take this drug
Niacin