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ACNP Pharm
Exam 1
142
Pharmacology
Graduate
09/30/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
Name 3 ABX for Otitis Media
Definition
1. Amoxicillin
2. Augmentin
3.Bactrim
Term
Name 2 ABX for Pharyngitis
Definition
1. Bicillin
2. Azithromycin
Term
Name 3 ABX for cellulitis
Definition
1. Keflex
2. Clindamycin
3. Vancomycin
(Bactim if no MRSA suspected)
Term
Name 3 ABX for GU infx
Definition
1. Cipro
2. Bactrim
3. Macrobid
Term
Name 5 ABX for C.A.P. (outpatient)
Definition
1. ZPack 2. Doxy 3. Cipro 4. Levaquin 5. Amoxil
Term
Folate Synthesis Inhibitors
Definition
1. Sulfa
2. Aminoglycosides
3. TB drugs
4. Dapsone
Term
ABX combination for C.A.P. (inpatient)
Definition
1. 3rd generation cephalosporin + zithromycin + cipro/levaquin +/- carbapenem
Term
ABX combination for hospital-acquired PNA
Definition
3rd generation cephalosporin + cipro/levaquin + carbapenem +/- vancomycin
Term
ABX combination for sepsis
Definition
3rd generation cephalosporin + vancomycin + carbapenem
Term
Treatment for gonorrhea/chlamydia (always treat together)
Definition
1. 1 GM rocephin + zithromycin 
2. 1 GM rocephin + doxy or levaquin
Term
ABX for ruptured abdominal viscera
Definition
Cipro + Flagyl
Term
Ribosome Synthesis Inhibitors (6)
Definition
1. Aminoglycosides


2. Chloramphenicol


3. Clindamycin
4. Linezolid
5. Macrolides
6. Tetracyclines
Term
Nucleic Acid Inhibitors (4)
Definition
1. Flagyl
2. Fluoroquinolones
3. Macobid
4. Rifampin
Term
Cell Wall Inhibitors (6)
Definition
1. Carbapenems
2. Cephalosporins
3. Monobactams
4. Mupiricin
5. PCN
6. Vancomycin (glycopeptide)
Term
Name 2 ABX for Trichomoniasis
Definition
1. Flagyl 2GM PO x 1
2. Tinodazole 2GM PO x 1
3. Flagyl 500 mg PO x 7 days
Term
Name ABX treatment for PID
Definition
1. Levaquin 500mg PO x 14 days
2. Ofloxacin 400mg PO BID x 14 days
** with or without Flagyl 500mg PO BID x 14 days
Term
ACE-Inhibitors: How do they work?
Definition

Blocks conversion of Angiotensin I to Angiotensin II

↓ Aldosterone

↑ K

↓ breakdown of bradykinin (results in bradykinin build-up)

↓TGF-β (↓ scar tissue post MI)

Renal protective (↓ efferent arteriole constriction)

Peripheral vasoconstriction (↓ afterload)

 

Term
ACE-Inhibitors: side effects
Definition

Dry cough (bradykinin build-up)

Hyperkalemia

Angioedema (bradykinin build-up, non-allergic)

Renal insufficiency (↓ renal perfusion esp in renal stenosis

** Contraindicated in pregnancy

Term
Angiotensin Receptor Blockers (ARBs): What do they do?
Definition

↓ Aldosterone

↑ K

↓ TGF-β

Peripheral vasodilation (↓ afterload)

No effect on bradykinin

Same benefits as ACE-Is but without as many side effects

 

Term
ARBs: side effects
Definition

Hyperkalemia

Renal insufficiency (esp. in renal artery stenosis)

** Contraindicated in pregnancy

Term

Calcium Channel Blockers: name the 3 types and give examples

 

Definition

1. Dihydropyridines (Amlodipine, Nicardipine, Nifedipine, Nimodipine)

2. Phenylalkylamines (Verapamil)

3. Benzothiazepines (Diltiazem)

Term
Calcium Channel Blockers: What do they do?
Definition

Act on voltage-gated channels

Block influx of Ca into cells

↓ Inotropy

↓ Chronotropy

↓ Dromotropy

Term
Calcium Channel Blcokers: Dihydropyridines
Definition

Peripherally vasoconstrict (↓ afterload)

Dilate coronary vessels

Have no effect on SA node

Used for HTN, angina

Term
Dihydropyridines: side effects
Definition

HA Fatigue

Nausea

Reflex tachycardia

LE edema

Constipation

Dizziness

Term
Calcium Channel Blockers: Phenylalkylamines
Definition

Significant conduction suppression

↓ AV node conduction

↓ HR

↓ CO

↓ strength of contractions

Peripherally vasoconstrict (↓ afterload)

Dilate coronary vessels

** Used for SVT, Angina, ↓ CO, ↓ HR

Term
Phenylalkylamines: side effects
Definition
LE edema
HA
Constipation
Sinus arrest (AV block)
Weakness
Hepatitis
Term
Calcium Channel Blockers: Benzothizepines
Definition

Significant coronary vasodilation

Significant peripheral vasodilation

↓ SA and AV node conduction

↓ Contractility

** Used for HR/BP control, angina, rhythm control

Term
Benzothiazepines: side effects
Definition
Bradycardia
Heart block
LE edema
Palpitations
Tachycardia
Constipation
Term
Beta Blockers: Nonselective (4)
Definition
1. Corgard
2. Propanolol
3. Tipolol (optic)
4. Labetalol (has intrinsic sympathomimetic activity)
Term
Name 4 β1 Selective Drugs
Definition

1. Atenolol

2. Esmolol

3. Metoprolol

4. Nebivolol

(no drugs are only cardioselective, all have some β2 activity)

Term
Benefits of β1 Blockade
Definition

↓ HR

↓ BP

↓ CO

↓ Strength of contractions

↓ Conduction

↓ Renin production

↓ Free fatty acids

Term
β Blockers: side effects
Definition

Bradycardia

Heart block

Hyperkalemia

Bronchospasm

Fatigue

Depression

Vivid dreams

Impotence

N/V/D/C

↓ Hypoglycemia sx 

 

 

Term
Name 3 α1 Blockers
Definition

1. Cardura

2. Minipress

3. Hytrin

Term
α1- Blockers: effects
Definition

Arterial and venous dilatation

↓ BP

↓ BPH

↑ Urine flow

May ↑ potency

Term
α1 Blockers: side effects
Definition
Postural hypotension
Term
Name 2 drugs with α1, β1, and βeffects
Definition

1. Carvedilol (Coreg)

2. Labetalol

Term
Name 2 Centrally-Acting α2 Agonists
Definition

1. Methyldopa (safe in pregnancy)

2. Clonidine

Term
Centrally-Acting α2 Agonists: What do they do?
Definition

↓ Sympathetic outflow

↑ Parasympathetic outflow

↓ Epi & Norepi release

↓ HR

↓ Speed of conduction

↓ Strength of contraction

Preserve CO & GFR

 

Term
Centrally-Acting α2 Agonists: side effects
Definition

SedationDry Mouth

Constipation

Dizziness

Weakness

HA 

Bradycardia

** Rebound HTN if stopped abruptly (wean!!)

Term
Name 2 Direct Vasodilators
Definition

1. Hydralazine

2. Minoxidil

Term
Direct Vasodilators: What do they do?
Definition

Inhibit arterial constriction by opening K channels

(↑ polarization)

↓ BP

↓ Afterload

** In long term use:

1. Consider use of Loop to prevent fluid overload

2. Consider use of βB to control/prevent HF 

Term
Direct Vasodilators: side effects
Definition

Rebound tachycardia

Hirsutism (Minoxidil)

HA

Postural hypotension

Fluid retention

Angina

↑ ANA (Lupus syndrome)

Palpitations

S3S4

Term
Name 3 Thiazide Diuretics
Definition

1. HCTZ

2. Metolazone

3. Chlorthiazide (Diuril)

Term
Thiazides: What do they do?
Definition

Inhibit reabsorption of Na, Cl and H2O from the distal convoluted tubule

Promote diuresis

↓ Na

↓ K

↓ Volume

↓ BP

↑ Tubular reabsorption of Ca

Promote vascular smooth muscle relaxation

1st line HTN mgmt

Term
Thiazides: Uses
Definition

HTN 

HF

Enhances effect of some meds

Mgmt of Ca based kidney stones 

Edema

Less diuresis than Loops

** No benefit > 25mg ** only use in normal renal fx

Term
Thiazides: side effects
Definition

Hyponatremia

Hypokelamia

Hypercalcemia

Hypotension

Dizziness

Weakness

↑ Uric acid retention (Gout)

Associated risk with Sulfa allergy (Stevens Johnson)

 

Term
Name 3 Loop Diuretics
Definition

1. Furosemide

2. Bumetanide

3. Torsemide

Term
Loop Diuretics: What do they do?
Definition

Inhibit reabsorption of Na, K and Cl from the ascending limb of the Loop of Henle

↑ Osmolality of filtrate

↓ BP

↓ SV

↓ CO

Induce prostaglandin synthesis, causing renal vasodilation

** ok to use in impaired renal fx

Term
Loop Diuretics: Uses
Definition

HTN

Fluid overload

CHF

Hyperkalemia

Hypercalcemia

Term
Loop Diuretics: side effects
Definition

Hypotension

Hypokalemia

Hyponatremia

Hypocalcemia

↓ Renal perfusion

Ototoxicity

↑ Uric acid production (Gout)

Nephrotoxicity (if given with other renal toxic meds)

Associated with Sulfa allergy

Term

K-Sparing Diuretics:

Name two types and their associated drugs

Definition

1. Aldosterone Inhibitors: Aldactone

2. Late distal-tubule blockers: Triamterene

Term
Aldosterone Inhibitors: What do they do?
Definition

↑ Na and H2O excretion

↑ K reabsorption

Term
Late Distal Tubule Blockers: What do they do?
Definition

Block Na and K transport proteins

↑ Na and H2O excretion

↑ K reabsorption

** Drug is weak and rarely used

Term
ACE-I/ARB/RI/Diuretic Patient Mgmt
Definition

Baseline BMP (reassess in 7 days)

Yearly BMP

Stop if creatinine triples

Reassess BP in 2-4 weeks

Check serum osmolality if concern for dehydration

Term

Carbonic Anhydrase Inhibitor (Diamox): 

What does it do?

Definition

**Not for HTN mgmt**

↓ HCOreabsorption from the tubular filtrate

↑ Osmolality of tubular filtrate

Term
Diamox: Uses (4)
Definition

1. Acute angle closure glaucoma

2. Altitude sickness

3. Pseudotumor cerebrii

4. Metabolic alkalosis

Term
Osmotic Diuretics (Mannitol): What does it do?
Definition

↑ Osmolality of ECF

↑ Fluid shift from ICF to ECF

↑ Osmolality of tubular filtrate

↓ H2O reabsorption

↓ Circulating volume

↑ Diuresis

Term
Mannitol: Pre-diuretic effects
Definition

Volume overload

Pulmonary edema

Hyponatremia

Term
Mannitol: Post diuretic effects
Definition

Hypovolemia

Hypotension

Hypernatremia

Term
JNC VII HTN Classification
Definition

Normal: <120/<180

 

Prehypertensive: 120-139/80-89

 

Stage 1: 140-159/90-99

 

Stage 2: ≥160/≥100

Term
Stage 1 HTN Mgmt
Definition

Lifestyle modification +

Thiazide diuretic

 

**May consider adding ACE-I, ARB, CCB or BB if ≥ 2 risk factors

Term
Stage 2 HTN Mgmt
Definition

Lifestyle modification + 

Two drug combination: Thiazide + ACE-I, ARB, CCB or BB

Term
Hypertensive Crisis (2 forms)
Definition

1. Hypertensive Urgency: >180/>110

2. Hypertensive Emergency: >180/>110 + s/s of end organ damage

Term
Hypertensive Urgency: Medication
Definition

Clonidine 0.3mg PO

** Goal with PO meds is to lower BP by 25%

Term
Hypertensive Emergency: Name 7 drugs (IV)
Definition

1. Nitroprusside

2. Nitroglycerin

3. Labetalol

4. Esmolol

5. Hydralazine

6. Nicardipine

7. Phentolamine

Term
Nitroprusside: Important facts
Definition

Rapid acting

Arterial vasodilation > venous (↓afterload)

0.25-10 mcg/kg/min

RBCs metabolize it to NO and cyanide 

NO activates cGMP → protein kinase G → smooth muscle relatation

 

Term
Nitroprusside: side effects
Definition

Hypotension

Reflex tachycardia

Cyanide toxicity (parasthesias, visual Δ, acidosis, delirium, arrhythmias, increased risk with hepatic or renal insufficiency)

** Co-administration of sodium thisulfate will minimize toxicity

Term
Nitroglycerin: Important facts
Definition

Converted to NO, causes vasodilation

More venous than arterial dilation

Preferred in CAD

Routes: SL, Transdermal, IV

Term
Nitroglycerin: side effects
Definition

Vasodilation

Orthostasis

HA

Reflex tachycardia

Flushing

Methemoglobinemia (treated with methylene blue)

Tolerance

Term
Labetalol: How does it work?
Definition

β > α

↓ HR

↑ Vasodilation

Term
Labetalol: side effects
Definition

Orthostasis

Heart block

Bronchospasm

N/V

Term
Esmolol: How does it work?
Definition

β1 Blocker

↓ HR

** Used for HTN emergency, Aortic dissection

Term
Esmolol: side effects
Definition

Hypotension

Heart block

Bronchospasm

Term
Hydralazine
Definition

Arterial vasodilator

Can cause reflex tachycardia

** Indicated in eclampsia

** Do not use in aortic dissection

Term
Nicardipine
Definition

Preferred in Neuro events

Good cerebral and peripheral vasodilation

Term
Phentolamine
Definition

α and β Blocker

** Indicated in catecholamine crisis

** May be injected locally to couteract vasopressor infiltration

Term
Heparin (unfractionated): How does it work?
Definition

Potentiates the activity of antithrombin III on thrombin

Inactivates thrombin

Inactivates factors IXa, Xa, XIa, XIIa

Prevents development of clots and extension of existing clots

Biological half-life is dose-dependent

Term
Heparin (unfractionated): Indications for use
Definition

VTE/PE prophylaxis

VTE/PE mgmt

Peripheral arterial thrombus mgmt

ACS- STEMI

Interventional cardiology

Prevention of thrombus with venous access devices

Term
Heparin (unfractionated): Dosing
Definition

VTE prophylaxis: 5,000u Q8-12hrs

VTE treatment:

IV: Bolus 50-100 (80) units/kg

then 15-25 (18) units/kg/hr

SQ: 10,000-20,000 units initially

then 8,000 to 10,000 units Q8hrs

Term
Heparin (unfractionated): complications
Definition

Hemorrhage

Thrombocytopenia

HIT

** reveral agent: Protamine Sulfate 

May cause anaphylaxis, angioedema, bradycardia

Term
Heparin (unfractionated): monitoring
Definition

PTT Q6-8hrs (goal 1.5-2.5x normal

Platelets

s/s of bleeding

 

Term
Low Molecular Weight Heparin (Lovenox, Dalteparin, Fondaparinux): How does it work?
Definition

Inactivates Factor Xa

Inhibits conversion of prothrombin to thrombin

Peaks 3-5hrs post injection

Duration: 12 hours

 

Term
LMWH: indications for use
Definition

VTE/PE prophylaxis

VTE/PE mgmt

ACS- STEMI

Term
LMWH: advantages over Heparin
Definition

Binds with protein, so more predictable

Less effect on platelets

Term
LMWH: complications
Definition

Hemorrhage

Thrombocytopenia

Hypochromic anemia

Fever

Elevated LFTs

Term
LMWH: mgmt
Definition

No need to monitor PT or PTT

Can measure anti-Factor Xa

Monitor CBC, LFTs

Term
Warfarin: What does it do?
Definition

Inhibits vitamin K dependent clotting factors

(II, VII, IX, X)

Has no direct effect on thrombin

**100% bioavailable through ingestion

Term
Warfarin: Indications for use
Definition

DVT treatment and prophylaxis

AFib (45-85% reduction in CVA)

Prosthetic valve replacement

** Takes 5 days to be therapeutic, start with Heparin or LMWH

Term
Warfarin: Administration
Definition

Food alters metabolism

99% protein-bound

40 hour 1/2 life

 

Term
Warfarin: Potentiators 
Definition

Age

HF

Hepatic

Hyperthyroidism

Antibiotics

Amiodarone

Cimetedine

Fluconazole

Metronidazole

Phenytoin

 

Term
Warfarin: Inhibitors
Definition

Hypothyroidism

Nephrotic syndrome

Barbiturates

Griseofulvin

Carbamazepine

Nafcillin, Rifampin

Sucralfate

Diuretics

Vitamin K

Term
Warfarin: Adverse effects
Definition

Bleeding

Teratogenicity

Term
Warfarin: Dosing
Definition

Start 5mg PO at bedtime

Monitor Pt/INR in 24-48 hours

Adjust dose as needed (2-5mg/day)

Goal: INR 2-3

Prosthetic valve: 2.5-3.5

Once stable, monitor Q2wks

Term
Warfarin: Management of supratherapeutic levels
Definition

INR 2.5-3: reduce dose if needed

INR >3: stop for 24-48hrs, then lower dose

INR 6-10 and no bleeding: Vit K 0.5-1mg IV

INR 10-20 and no bleeding: Vit K 3-5mg IV

INR >20 or serious bleeding: Vit K 10mg IV and

2-4 units FFP

Term
Dabigatran (Pradaxa): How does it work?
Definition

Direct thrombin inhibitor

Binds directly to thrombin with high affinity and specificity

Maximum benefit within 2-3 hrs of administration

12 hour 1/2 life

Term
Dabigatran (Pradaxa): Indications
Definition

Non-valvular Afib, VTE prevention

** Not recommended for prosthetic valves, severe renal dz, advanced liver dz or impaired coagulation

 

** no lab test, no antidote, cleared by dialysis

** Can be counteracted with FFP

Term
Dabigatran (Pradaxa): side effects
Definition

Dyspepsia

N/V/D

↑ risk of GIB

Term
Factor Xa Inhibitors (2)
Definition

1. Enoxaparin (Lovenox)

2. Rivaroxaban (Xarelto)

Term
Direct Thrombin Inhibitors (3)
Definition

1. Dabigatran (Pradaxa)

2. Argatroban

3. Bivalirudin (Angiomax)

Term
Thrombin Inactivator (1)
Definition
1. Heparin
Term

Vitamin K Clotting Factor Inhibitor (1)

Which clotting factors are affected (4)?

Definition

Warfarin

1. II

  2. VII

 3. IX

4. X

Term
Anticoagulants used in HIT (2)
Definition

1. Argatroban

2. Bivalirudin

Term
Antiplatelet Agents (6)
Definition

1. ASA

2. Dipyridamole (Persantine)

3. Ticopidine (Ticlid)

4. Clopidogrel (Plavix)

5. Prasugrel (Effient)

6. Glycoprotein IIb IIIa inhibitors

(Reopro, Integrilin, Aggrastat)

Term
ASA: How does it work?
Definition

Blocks cyclooxygenase (COX) which prvents the synthesis of thromboxane A2 from arachidonic acid is platelets

Suppresses platelet aggregation

Effect is irreversible, lasts the life of the platelet

Normal aggregation returns 36 hours after discontinuation

Preferred over all NSAIDs

** stop 4-6 days prior to surgery

Term
Dipyridamole (Persantine): What does it do?
Definition

Inhibits ADP and ATP te reduce platelet adhesion

Causes coronary artery vasodilation

Term
Ticlodipine (Ticlid): How does it work?
Definition
Interferes with platelet ADP induced binding to fibrinogen Decreases platelet aggregation
Term
Ticlodipine (Ticlid): major side effect
Definition
Bone marrow suppression
Term
Clopidogrel (Plavix): What does it do?
Definition

Blocks ADP-induced platelets from platelet binding

Inhibits thrombus formation

Irreversible

Term
Clopidogrel (Plavix): Cautions
Definition

Avoid concurrent use with herbals

(gingko, garlic, ginger, ginseng)

Various CYP450 interactions

Term
Prasugral (Effient): How does it work?
Definition

Same as Plavix: blocks the ADP-induced platelet binding

Inhibits thrombus formation

** No major CYP450 interactions

Term
Glycoprotein IIb/IIIa inhibitors (Reopro, Integrilin, Aggrastat): How do they work?
Definition
Bind to the IIb/IIIa receptor on the surface of platelets to inhibit platelet aggregation
Term
Name 3 Fibrinolytics
Definition

1. r-tPA (Alteplase, Activase)

2. Reteplase (Retavase)

3. Tenecteplase (TNKase)

Term
Fibrinolytics: How and why are they used?
Definition

Administered consurrently with anticoagulants to prevent new clots

All 3 are indicated for STEMI, line occlusion, CVA

**f-tPA is only drug approved for CVA, STEMI and PE

Term
r-tPA: How/when to use for CVA
Definition

Used in ischemic CVA  with negative CT

Use in 3hrs of onset!

** May use intra-arterial r-tPA within 6 hour of symptom onset

 

Term
Name 3 classes of drugs used for angina
Definition

1. Nitrates

2. β-Blockers

3. Calcium Channel Blockers

 

Term
Nitroglycerin: How does it work?
Definition

Metabolized to NO which causes vasodilation

Venous > arterial

↓ Myocardial O2 demand

Vasodilates epicardial arteries

↓ Preload

↓ Afterload

Term
Nitroglycerin: Types
Definition

NitroQuik (SL)

Nitropaste (transdermal)

Isosorbide mononitrate (PO)

Isosorbide dinitrate (PO)

Term
Isosorbide mono- vs. dinitrate: What's the difference?
Definition

Mononitrate (Imdur) is already a metabolite, so doesn't undergo hepatic first-pass

Lasts 6-10 hrs

Dinitrate (Isordil) undergoes hepatic first pass

Lasts 4-6 hrs

 

** Pregnancy category C

Term
Nitrates: Ranaolazine (Ranexa)
Definition

Inhibits late sodium current and reduces the calcium concentration in the myocytes

Indicated fro chronic angina not controlled by other agents

Term
Chylomicrons: What do they do?
Definition
Transport lipids and dietary cholesterol from the GI tract throughout the body
Term
Very Low-Density Lipoproteins (VLDLs): What do they do?
Definition

Transport trigs from the liver throughout the body to adipose tissue and muscles

Accept cholesterol from HDLs

May play a role in atherosclerosis

Unable tp measure directly, appear as a percentage

"very bad cholesterol"

Term
Intermediate-Density Lipoproteins: What are they?
Definition

Formed when VLDLs lose trigs

Converted by the liver to LDLs

Term

Low-Density Lipoproteins (LDLs):

How do they work and what do they do?

Definition

Synthesized by the liver

Transport cholesterol throughout the body

Synthesis increases with dietary intake of cholesterol

Combination of trigs, cholesterol, phospholipids and proteins

Definitely associated with atherosclerosis

Term
High-Density Lipoproteins: How do they work?
Definition

Synthesixed in the liver

Accepts free cholesterol from tissues and transports it back to the liver

Increases with estrogen, weight loss and estrogen

Decreases with obesity, elevated lipids, smoking and sedentary lifestyle

Made up of trigs, cholesterol, phospholipids and protein

Cardioprotective

 

Term
HDL Goals
Definition

Men > 40mg/dl

Women > 50mg/dl

As level increases, CV risk decreases

Term
Triglyceride Goals
Definition

Goal: <120 mg/dl

High: >200 mg/dl

Very High: > 1,000 mg/dl

As level increases, risk of CV dz and pancreatitis decreases

Term

LDL <130 and HDL >40

with < 2 risk factors

Definition

Repeat test Q5yrs

TLC education

Term

LDL 130-159 and HDL >40

with <2 risk factors

Definition

Repeat test Q1-2yrs

TLC education

Term

LDL >160 and/or HDL <40

with > 2 risk factors

Definition

Start medication

TLC education

Term
Trigs >400mg/dl only
Definition
TLC education
Term
Trigs > 400 and altered LDL and/or HDL
Definition

Medication therapy

TLC education

Term
Bile Acid Sequestrant Resins: How do they work?
Definition

Binds bile acid in the intestines and prevents their absorption

Leads to an increase in production of bile acids which consumes cholesterol and decreases LDL levels

Term
Bile Acid Sequestrants: Examples (3)
Definition

1. Cholestyramine (Questran)

2. Colestipol (Colestid)

3. Colesevelam (Welchol)

Term
Nicotinic Acid (Niacin): What does it do?
Definition

↓ LDL, VLDL, Trigs

Inhibits adipose tissue lipolysis

↓ catabolism of HDLs

↑ HDL

Term
Nicotinic Acid: side effects
Definition

Flushing

Burning/itching of upper body

Nausea

Anorexia

Dizziness

Hypotension

Hyperglycemia

Increased uric acid levels (gout)

Term
HMG-CoA Reductase Inhibitors (Statins): How do they work?
Definition

Inhibit cholesterol synthesis in the liver

Should be taken in the evening since most cholesterol is formed at night

** contraindicated in pregnancy and lactation

Term
Statis: Benefits
Definition

Decreases total cholesterol and LDL by 40%

HDL may increase 20%

May decrease Trigs

 

Term
Statins: side effects
Definition

GI: bloating, flatulence, dyspepsia

Hepatotoxicity

Myalgias and rhabdo.

** Monitor LFTs and CPK at baseline, 6wks, quarterly x 1 year then semi-annually

Term

Cholesterol Absorption Inhibitors (Zetia):

What do they do?

Definition

Inhibit cholesterol absorption at the brush border of the small intestines

Reduce cholesterol stores, ↓ serum cholesterol levels

Beneficial if statins are not effective or well-tolerated

Often used in combination with a statin

** contraindicated in liver dz and pregnancy

Term

Fibric Acid Derivatives (Gemfibrozil, Fenofibrate):

How do they work?

Definition

↓ lipolysis in fat tissue, which ↓ free fatty acids for hepatic trig synthesis and ↓ VLDL levels

** Useful in the patient with high trigs that do not respond to other meds

Approved for trigs >750mg/dl

Term
Fibric Acid Derivatives: side effects
Definition

GI: N/V/D/B

Hepatic: elevated LFTs

Hyperglycemia

Cholelithiasis and cholecystitis

Myalgia

Rash

Leukopenia

** Pregnancy category C

Term
Omega-3 Fatty Acids: What do they do?
Definition

↓ Hepatic trig synthesis

Contains EPA and DHA

** Pregnancy category C

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