Touro Yr2 Block I Pharm Anti-Hyperlipidemics

Front 1

Atherosclerosis

Back 1

1. lipid accumulation
2. chronic inflammatory
3. leading cause morbidity and mortality
4. fatty streaks --> fatty plaques
5. Angina first sign

Front 2

Atherosclerosis prevention

Back 2

1. ACE inhibitors
2. NO
3. Vit C and E
4. Estrogen

Front 3

Atherosclerosis prevention
ACE inhibitors do what?

Back 3

1. lower BP
2. reduce oxidation of LDL

Front 4

what do apolipoproteins do?

Back 4

1. conductors in lipoprotein circulation
2. tell lipoproteins to interact w/ certain enzymes

Front 5

5 major classes of lipoproteins

Back 5

1. VLDL
2. IDL
3. LDL
4. HDL

Front 6

Liver can only release fats as?

Back 6

VLDL

Front 7

If LDL is not cleared what happens to it?

Back 7

it goes into vasculature.

Front 8

HDL is formed d/t _________ and does what?

Back 8

1. APO1
2. collects cholesterol

Front 9

Exogenous (intestinal pathway)
chylomicrons are rich in ?

Back 9

triglycerides

Front 10

Exogenous (intestinal pathway)
Apo C promotes ?

Back 10

interaction of chylocmicrons with Lipoprotein lipase on adipose and muscle tissue.

Front 11

ApoE mediates?

Back 11

removal of chylomicron remnants in to the liver.

Front 12

Plasma clearance of LDL

Back 12

1. done by liver and peripheral cells
2. LDL apo B-100

Front 13

Rate limiting enzyme in cholesterol biosynthesis?

Back 13

HMGCoA reductase.

Front 14

WHO classifciation. who has increased risk of atherosclerosis?

Back 14

2a LDL
2b LDL +VLDL

Front 15

coronary heart disease risk.
what should your lipid levels be?

Back 15

Total <200
LDL <130
HDL >60

Front 16

name 4 categories of lipid lowering drugs?

Back 16

1. statins
2. fibrates
3. cholesterol absorbtion inhibitors
4. Niacin

Front 17

Statins
Name Specific competitive inhibitors

Back 17

FLoPS
1. Fluvastatin
2. Lovastatin
3. Pravastatin
4. Simvastatin

Front 18

Statins
Name Long lasting inhibitors

Back 18

1. Atorvastatin
2. Rosuvastatin

Front 19

Statins MOA

Back 19

1. reduce endogenous production of cholesterol
2. --> reduced secretion of VLDL

Front 20

Statins effect on lipid profile?

Back 20

1. decrease LDL
2. decrease TG
3. increase HDL

Front 21

which two statins are inactive prodrugs?

Back 21

Lovastatin
Simvastatin

Front 22

When should Flovastatin be taken?

Back 22

at night b/c peak cholesterol synthesis occurs between midnight and 2 am

Front 23

Cardioprotective effects of Statins

Back 23

1. increase NO
2. stabilize plaque
3. decrease CRP
etc,

Front 24

Statins adverse effects:

Back 24

1. Increase in LFT
2. myalgia

Front 25

Statins : Serious S/E ?

Back 25

1. myositis
2. rhabdomylosis

Front 26

Name 3 drugs you can combine with Statins?

Back 26

1. bile acid sequestrants
2. Niacin
3. fibrates

Front 27

WARNING
Statins plus Fibrates can lead to? ?

Back 27

Serious myopathy

Front 28

name 2 fibrates?

Back 28

1. fenobrate
2. gemfibrozil

Front 29

Fibrates MOA ?

Back 29

1. PPAR alpha agonists
2. Increase LPL
3. decrease VLDL release from liver

Front 30

Fibrates effect on lipid profile?

Back 30

1. decrease LDL
2. increase HDL
3. ⇊ TG

Front 31

Firbrates is drug of choice for pt w/?

Back 31

Type 3 hypertriglyceridemia

Front 32

Fibrates pharmokinetics

Back 32

1. glucoronidation
2. renal excretion.

Front 33

Fibrates S/E ?

Back 33

1. GI
2. pruritis
3. rash
4. MYOSITIS
5. LITHIASIS

Front 34

Which Fibrate has increased risk of lithiasis?

Back 34

Clofibrate

Front 35

Which fibrate is Category X?

Back 35

gemfibrozil

Front 36

Fibrates. Need to be careful using it for pt who has?

Back 36

renal failure

Front 37

name cholesterol transporter blocker?

Back 37

Ezitimibe

Front 38

Bile acid sequestrants

Back 38

1. reduce cholesterol reabsorbtion
2. Use for severe hyperlipidemia as adjunct
3. Taste Bad

Front 39

Bile acid sequestrants MOA

Back 39

1. decreases cholesterol absorbtion
2. increase bile acid excretion
3 increase LDL receptor expression

Front 40

Bile acid sequestrants. Dont combine with?

Back 40

warfarin.
Will cause serious bleeding issues.

Front 41

Bile acid sequestrants
When should you take chlorthiazide, digoxin, warfarin?

Back 41

an hour before or 4 hrs after taking the Bile acid sequestrants

Front 42

Ezitemibe

Back 42

1. inhibits cholesterol transport in duodenum (NPCILI)
2. used with Statins

Front 43

Ezitemibe pharmacokinetics

Back 43

1. Oral
2. long half life
3. metabolized to glucuronide complex which is active

Front 44

Ezitemibe S/E

Back 44

1. GI issues
2. rash
3. angiodema
4. ENTERS MILK. NO PREGOS!!

Front 45

Why is ezetimibe better than Bile acid seq ??

Back 45

1. does not affect absorbtion of fat soluble vitamins and drugs
2. higher potency. dont have to take a ton of it.

Front 46

Vytorin is ?

Back 46

Ezetimibe and simvastatin

Front 47

Niacin is best drug for ?

Back 47

increasing HDL

Front 48

Niacin S/E?

Back 48

1. flushing
2. pruritis
d/t PG D production
3. Hepatoxicity
4. Impaired glucose tolerance. DONT USE IN DIABETICS
5. Gout
6 NO PREGGOS

Front 49

Reduce niacin S/E by?

Back 49

taking aspirin before.
Aspirin inhibits prostaglandins