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40 Cards in this Set
- Front
- Back
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what is the number one side effect of niacin?
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flushing
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what drug is contraindicated for p with high TRG, but is recommended if they have normal TRG's?
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Fibric ACIDS. lowers LDL with normal TRG's
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mixtures of fatty cholesterol and proteins in the blood that transport cholesterol, trg's and other lipids to various tissues.
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lipoproteins
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what is the optimal level for LDL cholesterol?
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<100
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what is the optimal level for HDL?
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low <40
high >60 |
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what is the desirable level for total cholesterol?
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<200
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what are some major positive risk factors that put patients at risk for hyperlipidemia
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smoking
HTN/ and/or BB low HDL family H/O men >45 women>55 |
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what is the one negative risk factor that works in favor of your patients health
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HIGH HDL
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what are the two main types in making the dx of hyperlipidemia?
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Primary: no s/s of CHD
SECONDARY: s/s of chd w/event |
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if a patient has no H/O CHD and less than 2 chd risk factors, what should their LDL goal be ?
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< 160
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29 y/o female has an LDL of 210 and otherwise normal chol panel + non-contributory PMH. what is your plan/treatment?
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start meds for elevated LDL. low end statin: lipitor 10mg QD. + educate about diet
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59 y/o female presents with an LDL 171, HDL 31 and is taking "some medication" for her high blood pressure. what is your plan/treatment?
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start meds due to 2 or more risk factors and LDL >160. crestor 10mg QD. plus possible combo of niacin extended release 1 gm QD to raise HDL
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40 y/o diabetic male presents with LDL 149, HDL 29 and TRG 160. what med is contraindicated ?
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fibric acid due to elevated TRG's.
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inhibits enzyme that is responsible for converting HMG-COA to mevalonate which is the rate limiting step in the production of cholesterol?
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STATINS (HMG CoA reductase inhibitors)
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what is the efficacy of the STATIN class?
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reduce LDL 18-55%
reduce TRG 7-30% reduce major coronary events |
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what is the strongest statin?
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crestor 5-40 mg QD.
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what is the weakest statin?
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lipitor 10-80mg QD
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what labs do we need to monitor in a patient who is on a statin?
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CPK
LFT's lipid levels |
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what does CPK measure?
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creatinine protein kinase: muscle breakdown
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what are some side effects of the statins?
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myalgias
arthralgias increased LFT's |
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before starting a patient on a statin what lab do you need?
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LFT for a baseline
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what is an absolute contraindication for statins?
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liver disease
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which med works by binding to bile acids to disrupt enterohepatic recirculation of bile acids?
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bile acid sequestrants
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what is the efficacy of bile acid sequestrants?
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reduce LDL 15-30%
increase HDL 3-5% may increase TRG's reduce CHD mortality |
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what is the major side effect for the bile acid sequestrants?
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constipation. it'a a binding bulk-forming agent.
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what is a CI of using a bile acid sequestrant?
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elevated TG >400
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what is the representitive example of a bile acid sequestrant?
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welchol 2.6- 3.8 gm QD
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what are known drug interactions for welchol?
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warfarin
BB Thiazides |
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what drug is available OTC that reduces LDL by 25% and trg by almost 50%?
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niacin
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this drug inhibits mobilization of free fatty acids from peripheral adipose tissue. VLDL synthesis reduced.
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Nicotinic acid=niacin
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what is the efficacy of niacin?
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lowers LDL 5-25%
lowers TRG 20-50% raises HDL 15-35% reduces coronary events and reduces total mortality |
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when is niacin contraindicated?
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in patients with:
liver disease gout PUD |
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which drug reduces the rate of fat production in the liver?
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FIBRIC acids
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which drug causes gall stones?
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fibric acid
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what drug should not be used for a patient with elevated trg?
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tricor (fibric acid) it increases the LDL
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this drug inhibits cholesterol absorbtion from the GI tract?
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zetia
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what is the efficacy of zetia?
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lowers LDL 15-20%
increases HDL by 3% |
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what is the number one side effect of zetia?
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rash then HA
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in management of high TRG's what is the goal of therapy?
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to prevent pancreatitis
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what drugs are used to treat high TRG's?
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fibrates or nicotinic acids
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