Naplex - Chapter 47 - Dyslipidemia

Front 1

strong 3A4 inhibitors?

Back 1

- itraconazole, ketoconazole, posaconazole, voriconazole

- erythromycin, clarithromycin, telithromycin

- HIV protease inhibitors

- cobicistat containing

- nefazodone, cyclosporine

- gemfibrozil, Danazol, Grapefruit juice

Front 2

what drugs given by SC?

Back 2

- alirocumab (Praluent)

- evolocumab (Repatha)

-mipomersen (Kynamro)

Front 3

how to take Niaspan?

Back 3

- Niaspan is taken at HS after a low-fat snack

Front 4

what are parameters use to assess on the Global Risk Assessment tool?

Back 4

- gender, age, race

- TC, HDL, BP

- antihypertensive drug is used?

- DM

- smoking status

Front 5

what is the max dose for lovastatin while patient takes verapamil?

Back 5

max dose of lovastatin is 20 mg QD

Front 6

when do you use primary prevention for high intensity of statin?

Back 6

- LDL >= 190

- DM, 40-75yo, LDL (70-189), ASCVD >=7.5%

- 40-75yo has MI

Front 7

when do you use secondary prevention for high intensity of statin?

Back 7

clinical ASCVD <= 75 years

Front 8

when do you use secondary prevention for moderate-intensity of statin?

Back 8

clinical ASCVD > 75 years

Front 9

Statin treatment for high intensity that will decrease LDL >= 50% ???

Back 9

- Atorvastatin 40-80 mg QD

- Rosuvastatin 20-40 mg QD

Front 10

what concerns for bile acid sequestrants?

Back 10

- The agents in this class can cause constipation and adequate fluid and fiber intake is required; a laxative may be needed.

- Instruct the patient to maintain adequate fluid intake and to take a multivitamin at another time of day.

Front 11

generic for Vascepa?

Back 11

icosapent ethyl

(will lower Trigs)

Front 12

WelChol can lower or raise TG?

Back 12

WelChol will raise TG ~5%

Front 13

What WelChol can do for the blood glucose?

Back 13

Welchol can lower hemoglobin A1C ~0.5% by decreasing postprandial blood glucose.

Front 14

what caution about Epanova?

Back 14

Epanova can increase bleeding risk

Front 15

what is Epanova?

Back 15

omega-3 carboxylic acid

Front 16

Niacin and gout?

Back 16

Niacin can raise uric acid levels and should be used with caution in patients with gout.

Front 17

what medications should be avoided with Simvastatin?

Back 17

- Lopid

- VFEND

- Biaxin

Front 18

what is the MOA of Statins?

Back 18

The statins block cholesterol synthesis by inhibiting the enzyme HMG-CoA reductase, which catalyzes the rate-limiting step in cholesterol synthesis.

Front 19

What need to be counseled on Advicor?

Back 19

Advicor contains a statin (lovastatin) and niacin extended-release.

There is a heightened risk of muscle toxicity. Instruct patients to report at once any unexplained muscle pain, tenderness, or weakness.

Front 20

Statin should be stop when?

Back 20

Statins should be stopped once the LFTs are 3 times above the upper limit of normal (ULN).

Front 21

in what conditions are the fenofibrate agents contraindicated?

Back 21

- Gallbladder disease

- Severe liver disease

- can NOT be used in nursing mother

Front 22

Counseling for Lovaza?

Back 22

- The usual dose of Lovaza is 4 capsules daily, which can be divided BID.

- Lovaza can be tried as an alternative to fenofibrates for lowering TGs.

- Lovaza should be used in addition to a low-fat diet.

- If the patient uses OTC fish oils, he/she may need to double the amount of capsules to get similar TG lowering.

Front 23

If a patient suffer from red, itchy skin from taking Niaspan, what is the counseling?

Back 23

- may take 325mg ASA 30mins before Niaspan to reduce the symptoms

- Avoid alcohol, spicy food

- symptoms should lessen over time

- take Niaspan at bed time

Front 24

when should the Simvastatin should be taken?

Back 24

Simvastatin is taken at bedtime, with or without food. Simvastatin has a short half life and must be in the body during sleep when most cholesterol synthesis occurs. The max dose for new starts is 40 mg/day.

Front 25

How often should the Global Risk Assessment tool be done if a patient is classified as low risk?

Back 25

every 4-6 years

Front 26

generic for Crestor?

Back 26

rosuvastatin

Front 27

what are the SE of taking statin?

Back 27

- risk of DM

- memory loss

- myopathy

Front 28

What fibrate must be taken 30 mins before breakfast and dinner?

(Lopid, Tricor, Lofibra, Trilipix, Fibricor)

Back 28

Lopid

Front 29

generic name for Livalo?

Back 29

pitavastatin

Front 30

what statin should be taken with the evening meal?

Back 30

Lovastatin immediate-release

(Mevacor)

Front 31

SE of Lovaza?

Back 31

- burping

- dyspepsia

- taste perversions

Front 32

generic for Mevacor?

Back 32

lovastatin

Front 33

generic for Advicor?

Back 33

Lovastatin/Niacin

Front 34

generic for Simcor?

Back 34

Simvastatin/Niacin

Front 35

what drugs could adversely affect the lipid profile?

Back 35

- cyclosporine

- amiodarone

- prednisone

- beta blocker

Front 36

what is dose for Simvastatin when pt takes 20mg ditiazem and ranolazine?

Back 36

- max dose is 10mg Simvastatin

Front 37

what statins can be taken anytime of the day?

Back 37

Crestor, Lipitor, Livalo, Lescol XL and Pravachol can be taken at any time of day.

Front 38

generic for Vytorin?

Back 38

simvastatin + ezetimibe

Front 39

Which of cholesterol-lowering drug classes require liver enzyme monitoring at baseline due to a risk of hepatotoxicity?

Back 39

Niacins, statin, and the fibrates could possibly cause liver damage and liver enzymes should be monitored.

Front 40

SE of Niacin?

Back 40

- increase blood sugar

- increase in uric acid

- flushing

Front 41

Which lipid lowering therapy is contraindicated in a patient with active peptic ulcer disease?

Back 41

Niaspan

Front 42

generic for Repatha?

Back 42

evolocumab

Front 43

brand for mipomersen?

Back 43

- Kynamro

(CI in Hepatic disease or moderate to severe hepatic impairment)

Front 44

A patient is started on Lipitor 20 mg daily. According to the ACC/AHA Blood Cholesterol Guidelines, when should the lipid panel be checked?

Back 44

in 4-12 weeks

Front 45

what fibrate has the highest risk of myopathy when combine with statin?

Back 45

- Lopid (gemfibrozil)

Front 46

What is the mechanism of action of alirocumab?

Back 46

Inhibits LDL receptor degradation allowing LDL to bind to the receptor on hepatocytes

Front 47

brand for lomitapide?

Back 47

Juxtapid

Front 48

what about lomitapide (Juxtapid)?

Back 48

- pregnancy X

- indicated for homozygous familial hypercholesterolemia

- box warning of hepatotoxicity

Front 49

what statin has the least potent?

Back 49

fluvastin

Front 50

Which lipid lowering therapy is contraindicated in patients with a history of gallstones?

Back 50

fibrates

Front 51

MOA of fenofibrates?

Back 51

Fenofibrates are peroxisome proliferator alpha activators.

Front 52

what other names niacin known by?

Back 52

- B3

- nicotinic acid