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26 Cards in this Set
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For patients with known cardiovascular disease
(secondary prevention) cholesterol lowering leads to |
A consistent reduction in total
~mortality ~recurrent cardiovascular events |
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Among patients without cardiovascular disease
(secondary prevention) cholesterol lowering data is |
Less conclusive
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LDL for existing CHD should be
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<100
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LDL for those with 2+ risk factors and 10-20% ten-year risk should be
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<130.
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LDL for those with 2+ risk factors and 0-10% ten-year risk should be
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<130.
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LDL for those with 0-1 risk factors should be
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<160.
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He effect of diet therapy varies considerably among individuals
as some patients will have striking reductions in LDL cholesterol—up to what percent? |
20-30
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A cholesterol-lowering diet recommends reducing total fat to what percent?
Saturated fat? Dietary cholesterol in mg? |
25–30%
7% 200mg |
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This diet is equally effective at lowering LDL cholesterol but is less likely to lead to reductions in HDL cholesterol.
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Mediterranean diet
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Soluble fiber
Oat Bran or Psyllium may reduce LDL cholesterol % ? |
5–10%
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When all of these elements are combined into a single dietary prescription
the impact of diet on LDL cholesterol may approach that of statin medications lowering LDL cholesterol by close to |
30%
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Consumption of what?...
increases LDL & decreases HDL h+ |
Trans fats
TRANS FATS are BAD |
What type of fats?
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HMG-Coag reductase inhibitors
representative drugs: Lovastatin Simvastatin Atorvastatin can reduce LDL by how much? can increase HDL by how much? |
Decrease 20-50%
10% Increase |
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Which statin has the greatest effect on triglycerides?
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Atorvastatin
(Lipitor) |
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What percent of Pts taking statins develop myopathy?
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0.2%
only a few develop Rhabdomyolysis |
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Interactions:
erythromycin itraconazole ritonavir can reduce metabolism and elevate levels can block warfarin metabolism and elevate warfarin levels What class? |
Statins
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Bile acid-binding resins
representative drugs: cholestyramine colestipol can reduce LDL by how much? What are 2 adverse effects? |
15-25%
constipation perianal skin irritation |
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Inhibits biliary and dietary cholesterol absorption in the brush border.
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Ezetimibe
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Ezetimibe reduces LDL by
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19-23%.
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Niacin
(nicotinic acid) Lowers LDL by how much? Increases HDL how much? |
(-) 20-25%
(+) 25-35% |
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What are 4 adverse effects of niacin?
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Flushing
pruritus liver enzyme increase gout PUD exacerbation |
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Fibric acid derivatives
representative drug: Gemfibrozil (Brand Name): (Gemcor, Lopid) can reduce LDL by how much? What about HDL? Reduce Triglycerides by how much? |
10-15%
15-20%. 40% |
Gemfibrozil
is used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and triglycerides (other fatty substances) in the blood in certain people with very high triglycerides who are at risk of pancreatic disease |
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Side effects of cholelithiasis
hepatitis myopathy and rhabdomyolysis don't use with a statin Can use with a bile acid-binding resin but separate the doses because they reduce fibrate absorption |
Fibric acid derivatives
representative drug: Gemfibrozil |
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Most useful drug combo in treating hyperlipidemia
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Ezetimibe w Statins
or bile acid-binding resin Combining Statins |
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Most dangerous hyperlipidemia treatment combo
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Fibrates and statins
increased risk of myopathies & Rhabdomyolysis. |
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Patients with very high levels of serum triglycerides are at risk for
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Pancreatitis
The pathophysiology is not certain since pancreatitis never develops in some patients with very high triglyceride levels. |
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