Phar 451 - Cv Risk And Prevention

Front 1

What is the definition of "primary prevention" for CVD?

Back 1

Trying to prevent CV events from originally happening

Front 2

What is the definition of "secondary prevention" for CVD?

Back 2

Preventing another CV events from taking place in people who already have Athersclerosis

Front 3

What is the goal of therapy for Hyperlipidiemia?

Back 3

To prevent Cardiovascular Events

Front 4

What is the main difference between Targeted and Tailored primary prevention therapy?

Back 4

Targeted = Based on Lipid values. Tailored = Based on Inherent risk

Front 5

According to the AHA, what types of patients should be treated with CVD prevention?(3)

Back 5

1) Patients with existing atherosclerosis

2) Most patients with diabetes

3) Patients with very high LDL

Front 6

What risk assessment tool is used by the Canadian CV Society?

Back 6

Modified Framingham Risk Score

Front 7

What risk assessment tool is used by the American Heart Association?

Back 7

AHA Pooled Cohort Equations

Front 8

According to the Canadian CV Society, what are the primary targets for LDL in patients with high FRS >20%?

Back 8

<2mmol/L or >50% decrease

Front 9

According to the Canadian CV Society, what are the primary targets for LDL in patients with medium FRS 10-19%?

Back 9

<2 mmol/L or >50% decrease

Front 10

According to the Canadian CV Society, what are the primary targets for LDL in patients with low FRS <10%?

Back 10

>50% reduction

Front 11

According to the Canadian CV Society, what are the alternate targets for LDL in patients with high FRS >20%?

Back 11

Apo B <0.8g/L. Non-HDL <2.6 mmol/L

Front 12

According to the Canadian CV Society, what are the alternate targets for LDL in patients with med FRS 10-19%?

Back 12

Apo B <0.8g/L. Non-HDL <2.6 mmol/L

Front 13

In the event of a person with clinical ASCVD and a candidate for statin therapy whose aged <75 yr, what would be the appropriate therapy?

Back 13

High Intensity Statins

[lowers LDL by approx >50%]

Front 14

In the event of a person with clinical ASCVD and a candidate for statin therapy whose aged >75 yrwhat would be the appropriate therapy?

Back 14

Moderate Intensity Statins

[lowers LDL by approx 30-50%]

Front 15

In the event of a person with with NO clinical ASCVD, and a LDL >5mmol/L what would be the appropriate therapy?

Back 15

High Intensity Statins

[lowers LDL by approx >50%]

Front 16

Patient aged 50, no clinical ASCVD, LDL <5mmol/L and diagnosed Diabetes, 10yr ASCVD risk <7.5%. What would be the appropriate therapy?

Back 16

Moderate Intensity Statins

[lowers LDL by approx 30-50%]

Front 17

Patient aged 50, no clinical ASCVD, LDL <5mmol/L and diagnosed Diabetes, 10yr ASCVD risk >7.5%. What would be the appropriate therapy?

Back 17

High Intensity Statins

[lowers LDL by approx >50%]

Front 18

Patient aged 50, no clinical ASCVD, LDL <5mmol/L and 10yr ASCVD risk >7.5%. What would be the appropriate therapy?

Back 18

Mod-High Intensity Statins

[lowers LDL by approx >30%]

Front 19

Do statins exhibit a CV risk reduction vs placebo?

Back 19

Yes

Front 20

Do Niacins exhibit a CV risk reduction vs placebo?

Back 20

No

Front 21

Do Fibrates exhibit a CV risk reduction vs placebo?

Back 21

Yes

Front 22

Does Ezetimibe exhibit a CV risk reduction vs placebo?

Back 22

No?

Front 23

Do PCSK9 inhibitors exhibit a CV risk reduction vs placebo?

Back 23

Unknown

Front 24

What are the effects of Niacin on LDL, HDL and TG?

Back 24

LDL: Decrease 5-25%.

HDL: Increase 15-35%.

TG: Decrease 20-50%

Front 25

What are the effects of Fibrates on LDL, HDL and TG?

Back 25

LDL: Decrease 5-20%.

HDL: Increase ~9%.

TG: Decrease ~30%

Front 26

What are the effects of Bile Acid Sequestrants on LDL, HDL and TG?

Back 26

LDL: Decrease 15-30%.

HDL: Increase 3-5%.

TG: Negligible

Front 27

What are the effects of Statins on LDL, HDL and TG?

Back 27

LDL: Decrease 18-55%.

HDL: Increase 5-15%.

TG: Decrease 7-30%

Front 28

What are the effects of Ezetimibe on LDL, HDL and TG?

Back 28

LDL: Decrease ~18%.

HDL: Negilible .

TG: Decrease ~8%

Front 29

What is the overall Relative Risk Reduction of Major Coronary Events due to Statins?

Back 29

~30%

Front 30

What is the overall Relative Risk Reduction of Stroke Events due to Statins?

Back 30

~20%

Front 31

What is the overall Relative Risk Reduction of All Cause Mortality due to Statins?

Back 31

10-17%

Front 32

"The effects of statins is independent of Gender, HTN, DM2, prior CAD" True or False?

Back 32

TRUE

Front 33

Which statins are preferred for patients with prior ischemic stroke?

Back 33

Atorvastatin 80

Front 34

Which statins are preferred for patients with general elevated CV risk?

Back 34

Atorvastatin 10, Atorvastatin 80, Simvastatin 40

Front 35

Which statins are preferred for patients with T2DM?

Back 35

Atorvastatin 10, Simvastatin 40

Front 36

Which statins are preferred for patients with CAD?

Back 36

Atorvastatin 80, Simvastatin 40, Simvastatin 20?

Front 37

Which statins are preferred for patients for the purpose of primary prevention of CVD?

Back 37

Rosuvastatin 20, Atorvastatin 10

Front 38

Which statins are preferred for patients >80 y/o?

Back 38

Pravastatin 40

Front 39

What was the result of the ENHANCE study where Ezetimibe+ Simvastatin was used compared to Ezetimibe?

Back 39

Much more LDL reduction with combo than with Ezetimibe alone, but very little difference in mean carotid intima thickness

Front 40

What was the result of the SEAS trial where Simvastatin plus Ezetimibe were compared to placebo?

Back 40

Much more LDL reduction with combo than with placebo , but very little difference in mean CV events

Front 41

What was the results of IMPROVE-IT where the Simvastatin mono-therapy were compared to Simvastatin and Ezetimibe?

Back 41

No difference in cv events

Front 42

When would Ezetimibe be used in patients?

Back 42

Reserved for patients not reaching LDL goal on statin alone

Front 43

What are the only two Adverse effects of statins that are considered more prominent than placebo?

Back 43

1) Asymptomatic elevated liver enzymes

2) Newly diagnosed diabetes

Front 44

What are the adverse effects of statin therapies that are indistinguishable from placebo?

Back 44

1) CK>10xULN 2) Back Pain

3) Muscle aches 4) Headache

5) Cancer 6) GI Upset

7) Renal Disorders 8) Suicide

9) Nausea 10) Diarrhea

11) Fatigue 12) Rhabdomyolysis 13) Constipation

Front 45

What are the adverse effects of statin therapies that are decreased from placebo?

Back 45

1) MI

2) Stroke

3) All Cause Death

Front 46

Which statins are affected by Grapefruit Juice?

Back 46

Atorvastatin, Simvastatin, Lovastatin

Front 47

Which of the statins have increased drug interactions?

Back 47

Fluvastatin < Cervistatin < Atorvastatin, Pravastatin < Lovastatin, Simvastatin

Front 48

Should you add Fibrates or Nicacins to Statin therapy?

Back 48

No, none of them have shown to add reduced CV risk and do not increase HDL levels

Front 49

Which of the statins have the greatest reduction in LDL?

Back 49

Rosuvastatin, Atorvastatin [>50%]

Front 50

Which of the statins have the lowest reduction in LDL?

Back 50

Fluvastatin, Pravastatin [<40%]

Front 51

Which of the statins need to be dosed at evening?

Back 51

Simvastatin

Front 52

"Niacin may worsen glycemic control in diabetic" True or False?

Back 52

TRUE

Front 53

What is the overall Relative Risk Reduction of Major CV events of Fibrates?

Back 53

10%

Front 54

What is the overall Relative Risk Reduction of Major Coronary Events of Fibrates?

Back 54

13%

Front 55

What is the overall Relative Risk Reduction of Stroke Events due to Fibrates?

Back 55

no effect

Front 56

What is the overall Relative Risk Reduction of CV death due to Fibrates?

Back 56

no effect