S1 - Falcon - Pharm Neuro Anti-Hyperlipidemia Drugs

Front 1

ANTI-HYPERLIPIDEMIA DRUGS

- what are the 5 drug classes

Back 1

- HMG CoA reductase inhibitor
("statins")

- Bile acid sequestrants
(cholestyramine & colestipol)

- Nicotinic acid

- Fibrates
(gemfibrozil, clofibrate, & fenofibrate)

- Cholesterol uptake inhibitor

Front 2

BILE ACID SEQUESTRANTS

- list drugs that are bile acid sequestrants

Back 2

- cholestyramine

- colestipol

Front 3

BILE ACID SEQUESTRANTS

- Bile acid sequestrants are resins that bind to what?

- the purpose of this binding is to prevent what?

- this prevention will force what to occur?

Back 3

- bile salts

- prevent reuptake of bile salts

- this forces body to make fore bile salts from cholesterol

Front 4

BILE ACID SEQUESTRANTS

- what blood levels are affected and how?

Back 4

- Lowers LDL cholesterol levels

(NOTE: these are older drugs and are less effective than newer ones)

Front 5

BILE ACID SEQUESTRANTS

- minor side effects

- major side effects include what effect?

Back 5

(very safe b/c local effects only)

- annoying GI
(bloating and constipation)

- Decreases absorption of lipid soluble drugs

Front 6

BILE ACID SEQUESTRANTS

- Bile acid sequestrants decrease absorption of drugs with what property?

- list some drugs with this property

Back 6

- Lipid soluble drugs

- Warfarin
- Thyroxin
- Vitamins K, A, D, E

- Propranolol
- Digoxin

Front 7

HMG-CoA REDUCTASE INHIBITOR

- MOA

Back 7

- blocks the rate limiting step in cholesterol synthesis

Front 8

HMG-CoA REDUCTASE INHIBITOR

- what changes are seen in blood levels

Back 8

Decrease in plasma:

- LDL
- VLDL

Front 9

HMG-CoA REDUCTASE INHIBITOR

- besides lowering cholesterol, statins also have what other beneficial effect?

Back 9

- Anti-inflammatory

Statins also block the formation of:
- Farnesyl groups
- Geranyl groups

Front 10

HMG-CoA REDUCTASE INHIBITOR

- although statins work great, they show even more efficacy if they are combined with?

Back 10

- Bile resins
(cholestyramine or colestipol)

Front 11

HMG-CoA REDUCTASE INHIBITOR

- one rare side effect is the increase in plasma levels of what?

- what are 2 other (rare) major SE?

Back 11

- Hepatic Transaminases

- Myopathy

- RHABDOMYOLYSIS

Front 12

HMG-CoA REDUCTASE INHIBITOR

- Rhabdomyolysis has an increased risk of occuring if statins are combined with?

Back 12

- Gemfibrozil (Fibrates)

- Nicotinic acid (Niacin)

Front 13

HMG-CoA REDUCTASE INHIBITOR

- what follow up therapy?

Back 13

Monitor patients for:

- LFTs
- Muscle ache Sx

Front 14

NICOTINIC ACID (NIACIN)

- describe MOA

- describe dosing

Back 14

- unclear
(unrelated to role as a vitamin)

- LARGE doses (2 to 6 grams / day)

Front 15

NICOTINIC ACID (NIACIN)

- what changes in blood levels are seen with large dosages of niacin?

Back 15

Increased
- HDL

Decreased
- LDL
- VLDL
- Triglycerides

Front 16

NICOTINIC ACID (NIACIN)

- what is the problem with administering niacin?

Back 16

- Difficult to take

Front 17

NICOTINIC ACID (NIACIN)

- early side effects seen with taking high doses of niacin?

- these early SE occur where on body?

Back 17

- Flushing
- Pruritis

- Upper body & Face

Front 18

NICOTINIC ACID (NIACIN)

- early SE of flushing and pruritis is associated with the production of what endogenous molecule?

- these early SE can be prevented how?

Back 18

- Prostaglandin D2

- PRE-TREATMENT of ASA

Front 19

FIBRATES

- name some fibrate drugs

Back 19

- Gemfibrozil
- Fenofibrate
- Clofibrate

Front 20

FIBRATES

- what is the MOA

- what does the MOA promote

Back 20

- activates Lipoprotein Lipase

- catabolism of VLDL

Front 21

FIBRATES

- what changes in the blood levels would be seen?

Back 21

Small Increase in HDL

Decrease
- LDL
- VLDL
- TG

Front 22

FIBRATES

- although generally well tolerated, what side effect might you see?

Back 22

- Myositis

- Hypokalemia

Front 23

FIBRATES

- Clofibrate has been associated with what major SE?

Back 23

- Gallstones

- Hepatobiliary neoplasm

Front 24

CHOLESTEROL UPTAKE INHIBITOR

- name the cholesterol uptake inhibitor

Back 24

- Ezetimibe

Front 25

CHOLESTEROL UPTAKE INHIBITOR

- Ezetimibe MOA

Back 25

- binds to Intestinal Lumen Protein

(which normally facilitates cholesterol uptake from FOOD)

Front 26

CHOLESTEROL UPTAKE INHIBITOR

- Ezetimibe has what effects on changes seen at the blood level

- research has shown that Ezetimibe has what effects on adverse outcomes

Back 26

- decreases LDL

- no proof of improvement has been shown

Front 27

CHOLESTEROL UPTAKE INHIBITOR

- Ezetimibe side effects

Back 27

- HA
- Diarrhea
- Liver damage