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43 Cards in this Set
- Front
- Back
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What is the MOA of statins?
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inhibit the conversion of HMG-CoA to mevalonate which is the rate limiting step for cholesterol synthesis. Improve endothelial function, decrease platelet aggregation, reduce inflammation
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What are the side effects of statins?
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Myalgias vs. myopathy/rhabdomyalosis
Liver problems |
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What are the contraindications for statins?
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Active or chronic liver disease
Relative: Women who may become pregnant |
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What enzymes should you order at baseline when treating with statins?
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CK, ALT
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How much do statins raise HDL?
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5-15%
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How much do statins lower LDL?
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18-63%
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How much do statins lower triglycerides?
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7-35%
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What is the MOA of bile acid resins?
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Bind bile acid resins in the intestinal lumen - stimulates hepatic synthesis of bile acids from cholesterol - increases cholesterol biosynthesis and the number of LDL receptors on the hepatocyte membrane - pulls LDL from serum
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How much do bile acid resins reduce LDL?
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15-30%
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How much do bile acid resins reduce HDL?
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3-5%
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What is the possible effect of bile acid resins on triglycerides?
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May increase them
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What are the side effects of bile acid resins?
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GI distress/constipation
Decreased absorption of other drugs |
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What is the condition contraindication to bile acid resins?
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Dysbetalipoproteinemia
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What are the 3 bile acid resins?
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Cholestyramine (Questran)
Colestipol (Colestid) Coleseveleam (Welchol) |
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What are the demonstrated therapeutic effects of bile acid resins?
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Reduce major coronary events
Reduce CHD mortality |
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What is the MOA of Niacin?
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Reduces the hepatic synthesis of VLDL which leads to a reduction in LDL synthesis
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How much does Niacin lower LDL?
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5-25%
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How much does Niacin lower triglycerides?
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20-50%
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How much does Niacin increase HDL?
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15-35%
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What are the side effects of Niacin?
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Flushing
Hyperglycemia Hyperuricemia Upper GI distress Hepatotoxicity |
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What are the contraindications to Niacin?
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Liver disease
Severe gout Peptic ulcer |
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What are the 3 formulations of Niacin?
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Immediate release (crystalline)
Extended release (Niaspan) Sustained release (Slo-Niacin) |
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What are the demonstrated therapeutic benefits of niacin?
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Reduces major coronary events
Possible reduction in total mortality |
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What is the MOA of fibric acid derivatives?
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Inhibit lipolysis of fat in adipose tissue; decrease liver uptake of free fatty acids and reduce hepatic triglyceride production, also inhibits the synthesis of VLDL carrier apoB
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How much is LDL lowered by fibric acid derivatives?
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5-20%
May raise with high TG |
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How much are triglycerides lowered with fibric acid derivatives?
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20-50%
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How much is HDL raised by fibric acid derivatives?
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10-20%
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What are the side effects of fibric acid derivatives?
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Dyspepsia, gallstones, myopathy
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What are the contraindications to fibric acid derivatives?
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Severe renal or hepatic disease
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What are the 2 fibric acid derivatives?
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Gemfibrozil (Lopid)
Fenofibrate (Tricor) |
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What are the demonstrated therapeutic benefits of fibric acid derivatives?
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Reduce progression of coronary lesions
Reduce major coronary events |
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What is the MOA of Ezetimibe (Zetia)?
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Inhibits cholesterol absorption in the small intestine leading to a decrease of intestinal cholesterol being delivered to the liver.
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How much does Ezetimibe lower LDL?
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18%
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How much does Ezetimibe reduce triglycerides?
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8%
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How much does Ezetimibe increase HDL?
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1%
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What is the major side effect with Ezetimibe?
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GI upset
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What is the condition contraindication for Ezetimibe?
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Caution in hepatic impairment
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What is the controversy associated with Ezetimibe?
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No cardiovascular outcome data
Post market study showed no added benefit |
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What are the two examples of fish oil?
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Lovasa
Omacor |
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How much does fish oil reduce triglycerides?
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7-45%
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How much does fish oil raise HDL?
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9%
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How much is the normal dose of fish oil?
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4 g/day
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High doses of fish oil have been associated with what?
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Thrombocytopenia
Bleeding disorders |
