Pharm 3

Front 1

What are the HMG-COA reductase inhibitor drugs?

Back 1

- Lovastatin
- mevacor
- these are the most effective agents currently available

Front 2

Where is the major effect of HMG-COA drugs?

Back 2

- in the liver
- marked first pass hepatic extraction

Front 3

Major effect of HMG-CoA?

Back 3

- reduce cholesterol synthesis in the liver by competitively inhibiting HMG-CoA reductase
- this is the rate limiting enzyme in cholesterol synthesis

Front 4

HMG-CoA

Back 4

- induce an increase synthesis of LDL reseptors
- this results in an increase in liver's extraction of LDL and reducing LDL in the plasma

Front 5

HMG-CoA
When used?
Adverse effects?

Back 5

- used in hypercholesterolemia and mixed hyperlipidemia
- increase in hepatic enzymes (hepatitis) and myalgia (myositis)
- should be discontinued if levels of creatine is found to be elevated

Front 6

drug of Nicotinic acid?

Back 6

- Niacin

Front 7

Mechanism of Niacin?

Back 7

- reduces VLDL secretion and increases VLDL clearance in plasma
- inhibits lipolysis in adipose tissue***
- decreases supply of FFA to the liver and hepatic synthesis of VLDL

Front 8

When is Niacin useful?

Back 8

- mixed hyperlipidemia because of it's favorable influence on serum levels of VLDL, LDL, and HDL
- can be combined with other drugs

Front 9

Niacin
Adverse effects

Back 9

- marked vasodilation and flushing of the skin ... may see pruritis
- treat above with aspirin
- elevation of serum transaminase
- gastric distress
- glucose intolerance

Front 10

Niacin should be avoided by..

Back 10

- pts with liver disease, peptic ulcer, or hyperuricemia and diabetes

Front 11

What drugs are Fibric Acid derivatives?

Back 11

- Gemfibrozil
- Lopid

Front 12

Fibric acid derivative mechanisms

Back 12

- decrease VLDL and tri's by increasing the activity of lipoprotein lipase and hydrolysis of VLDL
- promote delivery of tri's to adipose tissue

Front 13

When are fibric acid derivatives used?

Back 13

- primarily in hypertriglyceridemia
- also in mixed and HDL deficiency

Front 14

Fibric acid adverse effects

Back 14

- allergic reactions
- blood deficiencies
- myalgia
- POTENTIATES THE EFFECTS OF WARFARIN
- increase myopathy when given with HMG-COA

Front 15

what drugs are the bile acid binding agents?

Back 15

- Colestipol
- Colestid

Front 16

Bile acid binding mechanism

Back 16

- bind bile acids and prevent their absorptions
- this leads to the synthesis of replacement bile acids from cholesterol in the liver
- liver then increases the number of LDL receptors and removes LDL from plasma!
- COLESTIPOL DOES THIS

Front 17

Bile acid binders have no effect on

Back 17

- HDL or triglycerides

Front 18

Bile acid binders used with pts that

Back 18

- cannot tolerate other drugs
- or these are used in comb with other drug

Front 19

bile acid binder effects

Back 19

- NO SYSTEMIC EFFECTS
- GI effects:
nausea, bloating, constipation
- interfere with absorption of fat-soluble vitamins such as DIG, hydrochlorothiazide adn warfarin

Front 20

what are the inhibitor of intestinal cholesterol absortion drugs?

Back 20

- ezetimibe
- zetia

Front 21

Mechanism of inhibitors of intestinal cholesterol absorption drugs?

Back 21

- inhibits intestinal absoption of cholesterol adn phytosterols
- effective even in absense of dietary cholesterol because inhibits absorption of cholesterol excreted in bile