Term
| How often should fasting lipid profile be obtained in adults? |
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Definition
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Term
| Four groups of patients most likely to benefit from statin therapy? |
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Definition
1. Age 40-75 w/ DM and LDL-C of 70-189mg/dL
2. PMH of ASCVD
3. Age 40-75 w/ 10-yr ASCVD score of ≥7.5% and LDL-C 70-189 mg/dL
4. LDL-C ≥190mg/dL |
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Term
| 10-year ASCVD risk score should be calculated for patients with LDL-C level of? |
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Definition
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Term
| High intensity statin age cut-off is |
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Definition
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Term
| List high intensity statins (brand/generic) and dose ranges (two drugs) |
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Definition
Atorvastatin (Lipitor) 40-80mg Qday
Rosuvastatin (Crestor) 20-40mg Qday |
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Term
| High intensity statins lower LDL-C by _______% while moderate intensity statins lower LDL-C by ________% |
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Definition
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Term
| Bile acid resins: Brand/generic (3 drugs) |
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Definition
*Colesevelam | Welchol
* = on Top 200 List
Cholestyramine | Prevalite
Colestipol | Colestid |
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Term
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Definition
| Binds to bile acids forming insoluble complex that is excreted. This causes the liver to convert cholesterol into bile acids which decreases cholesterol stores. Liver then sends demand for more cholesterol resulting in the upregulation of LDL receptors and increased clearance of LDL-C from bloodstream. |
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Term
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Definition
Every GI issue imaginable
Increased TGs |
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Term
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Definition
| Binds to and decr. absorption of many drugs like: warfarin, digoxin, thiazides, levothyroxine, and mycophenolate |
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Term
|
Definition
Incr TGs
Decr LDL-C
Safe for liver disease pts
Colesevelam (Welchol) has least GI SEs
Do NOT admin w/ other meds. Take other meds 1hr before or 4hr after
Admin w/ food
Fiber supps may reduce GI SE |
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Term
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Definition
| Decr production of VLDL in liver resulting in decr production of LDL-C |
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Term
|
Definition
Liver disease
Active gout
Active PUD |
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Term
|
Definition
Flushing/itching
Nausea
Orthostatic hypotension
Incr LFTs
Myopathy
Hyperuricemia
Hypergylcemia |
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Term
|
Definition
Most effective drug for incr HDL-C
Decr LDL-C and TGs
Incr dose by <500mg Q4wk
PM dosing so flushing occurs while asleep
Take 325mg aspirin/NSAID 30 min prior to reduce flushing |
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Term
|
Definition
*Niaspan
* = On Top 200 Drug List |
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Term
| Fibric Acid Derivatives: brand generic |
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Definition
fenofibrate/fenofibric acid | Tricor, Fibricor, Lipofen, Triglide, Trilipix, Antara, Fenoglide
Gemfibrozil | Lopid |
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Term
| Fibric Acid Derivatives: CIs |
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Definition
Hepatic impairment
Renal impairment (severe)
Gall bladder disease
Gemfibrozil (Lopid) Only: Concurrent use with: statins, repaglinide, dasabuvir, selexipag |
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Term
| Fibric Acid Derivatives: SEs |
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Definition
N/V/D
Ab pain
Incr LFT
Myopathy
Severe rash
Anaphylaxis/angioedema |
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Term
| Fibric Acid Derivatives: DIs |
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Definition
Gemfibrozil (Lopid) only:
- CYP28 inhibitor
- Use with statins incr myopathy risk
- Use w/ repaglinide incr hypoglycemia risk
- Use with dasabuvir incr QT prolongation risk
Incr effects of warfarin and SUs
Decr cyclosporine effects |
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Term
| Fibric Acid Derivatives: Pearls |
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Definition
Decr TGs
Incr HDL-C
Fenofibrate preferred if using w/ statins
Adust dose for renal function
Admin with meals to decr GI SEs |
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Term
| Omega-3 Fatty Acids (Fish Oil): brand/generic (2 drugs) |
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Definition
lcosapent ethyl | Vascepa
Omega-3-Acid ethyl esters | Lovaza |
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Term
| Omega-3 Fatty Acids (Fish Oil): SEs (lcosapent (Vascepa)) only |
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Definition
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Term
| Omega-3 Fatty Acids (Fish Oil): DIs |
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Definition
| Incr bleed risk when used with antithrombotic agents |
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Term
| Omega-3 Fatty Acids (Fish Oil):Pearls |
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Definition
Decr TGs
Incr LDL-C (maybe)
Take lcosapent (Vascepa) w/ meals |
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Term
| Omega-3 Fatty Acids (Fish Oil): MOA |
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Definition
| Decr production of TGs in liver |
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Term
| Fibric Acid Derivatives: MOA |
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Definition
| Incr activity of lipoprotein lipase leading to ice breakdown of VLDL and decr in TGs |
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Term
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Definition
| Inhibits HMG-COA reductase preventing conversion of HMG-CoA to mevalonate (rate limiting step in cholesterol synthesis) |
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Term
| Statins: Brand/generic Top 200 (5 drugs) |
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Definition
*atorvastatin | Lipitor (H)
*rosuvastatin | Crestor (H)
*lovastatin | Altoprev
*pravastatin | Pravachol
*simvastatin | Zocor, Flolipid |
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Term
|
Definition
Liver disease
Pregnancy
Use of atorvastatin + cyclosporine
Use of lovastatin + 3A4 inhibitors
Use of simvastatin + CYP3A4 inhibitors, cyclosporine and/or danazol |
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Term
|
Definition
Incr LFTs
myopathy
N/V
constipation |
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Term
|
Definition
Atorvastatin, simvastatin, and lovastatin are 3A4 substrates
Fluvastatin and pitavastin are 2C9 substrates
**Pravastatin is NOT metabolized by CYP enzymes |
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Term
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Definition
Beware of interactions!
Most effective drug for decr LDL-C
Simvastatin also avaliable as oral suspension (FloLipid)
Admin in evening to coincide with cholesterol prod, timing
Adj pitavistatin and rosuvastatin for renal function |
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Term
| Lower maximum atorvastatin (Lipitor) dose when administered with which drugs? |
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Definition
clarithromycin
darunavir/ritonavir
fosamprenavir
fosamprenavir/ritonavir
itraconazole
nelfinavir
saquinavir/ritonavir |
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Term
| Lower maximum fluvastatin (Lescol XL) dose when administered with which drugs |
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Definition
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Term
| Lower maximum lovastatin (Altoprev) dose when administered with which drugs |
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Definition
amiodoraone
droneadrone
verapamil
diltiazem
danazol
lomitapide |
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Term
| Lower maximum pravastain (Pravachol) dose when administered with which drugs |
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Definition
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Term
| Lower maximum rosuvastatin (Crestor) dose when administered with which drugs |
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Definition
cyclosporine
gemfibrozil
lopinavir/ritonavir
atazanavir/ritonavir
semiprevir |
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Term
| Lower maximum simvastain (Zocor) dose when administered with which drugs? |
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Definition
amiodoraone
amlodipine
diltiazem
droneadrone
niacin
ranolazine
verapamil
lomitapide |
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Term
| Statins: combo drug (1 drug) |
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Definition
| simvastatin/ezetimibe | Vytorin |
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Term
| Cholesterol Absorption Inhibitors: brand/generic (1 drug) |
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Definition
*ezetimibe | Zetia
* = on Top 200 Drug List |
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Term
| Cholesterol Absorption Inhibitors: SE |
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Definition
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Term
| Cholesterol Absorption Inhibitors: CI |
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Definition
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Term
| Cholesterol Absorption Inhibitors: DI |
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Definition
inc effects of warfarin
incr levels of cyclosporine
cyclosporine + fibrates incr effects of ezetimibe (Zetia) |
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Term
| Cholesterol Absorption Inhibitors: pearls |
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Definition
decr LDL-C
Can be ADD-ON to statin |
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Term
| Cholesterol Absorption Inhibitors: MOA |
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Definition
| Prevents absorption of cholesterol in small intestine |
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Term
| 4 facts about lomitapide (Juxtapid); the onle MTP inhibitor |
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Definition
REMS program
DO NOT use if pregnant
3A4 substrate
Must take with a daily vitamin supp. |
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Term
| PCSK9 inhibitors: Storage |
|
Definition
Keep refrigerated
alirocumab (Praluent) can be kept at room temp for 30d if reqd |
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Term
|
Definition
| Inhibits binding of PCSK9 to LDL receptors on hepatocytes which increases the # of receptors avaliable to clear LDL from blood stream lowering LDL-C |
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Term
| PCSK9 inhibitors: brand/generic (two drugs) |
|
Definition
arlirocumab | Praluent
evolocumab | Reptha |
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Term
|
Definition
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Term
|
Definition
alrirocumab only:
diarrhea
incr LFTs |
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Term
|
Definition
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Term
|
Definition
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