Shared Flashcard Set

Details

lipid lower agents
pharm 2 exam 3
45
Health Care
Graduate
03/28/2009

Additional Health Care Flashcards

 


 

Cards

Term
5 types of lipid lowering agents
Definition

1. HMG-CoA Reductase inhibitors (statins)

2. Bile Acid-Binding Resins

3. Nicotinic Acid

4. Fibric Acid Derivative

5. Cholesterol Absorption inhibitors

Term
HMG-CoA reductase inhibitors
Definition

"statins"

Atorvastatin

lovastatin

pravastatin

fluvastatin

simvastatin

rosuvastatin

Term
which statin is the most potent
Definition
rosuvastatin
Term
which statin is the least potent
Definition
fluvastatin
Term
MOA statins
Definition

inhibits HMG-CoA reductase -> rate limiting

enzyme in cholesterol synth

Term

PK statins

Definition

first-pass met

p450

 

 

Term
tx use of statins
Definition

lowers all cholesterols and tris

EXCEPT HDL -> stays same or incr

Term
when should statins be dosed
Definition

at night!

Term
AE statins
Definition

liver probs

mm probs (myalgia/rhabdo)

renal probs in pts w/ pre-existing conditions

Term
will homozygous for familial hypercholesterolemia who lack LDL receptors benefit from statin use?
Definition
NO
Term
who should not use statins
Definition
prego, kids
Term
when should you d/c statins
Definition
mm pain (s/sx)
Term

what increases statins?

Definition
itraconazole, erythro, cyclosporine
Term
what should be avoided w/ statin use
Definition

grapefruit juice

fibrates->incr risk mm damage

Term
bile acid resin drugs
Definition

cholestyramine

colestipol

colesevelam

Term
MOA bile acid resins
Definition

large polymer w/ Cl ion -> exchange w/ bile acid

prevents bile acid resporption->

fall in intracellular cholesterol->

incr hepatic uptake of LDL-C (fall in plasma conc)

Term
tx uses of bile acid resins
Definition

decr LDL

used in pts who can't tolerate statins

DOC for phenotypes IIa and IIb hyperlipidemia

2nd line

Term
DOC for IIa and IIb hyperlipidemia
Definition
bile acid resins
Term
which drug is used to relieve pruritis in pts w/ biliary obst
Definition
cholestyramine
Term

PK bile acid resins

Definition

oral, powder, waffer

 

NOT ABSORBED

NOT METABOLIZED

Term
which is the safest of all lipid lowering drugs
Definition
bile acid binding resins
Term
AE bile acid binding resins
Definition

GI: constipation, bloating, indigestion, N

Rare: decr abs of fat-sol vitamins

Rare: folic/ascorbic acid abs. red.

Term
drug interactions of bile acid binding resins
Definition

LOTS -> form complexes

thiazides

dig

warfarin

tetracylines

aspirin

phenobarb

statins

Term
how do you prevent drug interactions w/ bile acid binding resins?
Definition

stagger dosages!

1-2 hrs before or 6 hrs after taking other drugs

Term
Nicotinic acid (niacin) MOA
Definition

red. hepatic VLDL and LDL syth secondary to inhibiting fatty acid mobilization from adipose tissue

inhibits tissue lipolysis reducing supply of FFA's

that liver uses to synthesize TG's for incorporated into VLDL

Term
tx uses of nicotinic acids
Definition

decr LDL and VLDL and incr in HDL

pts w/ type IIa and IIb familial

severe hypercholesterolemias

 

 

Term
what is the best agent for raising plasma HDL levels
Definition
nicotinic acid (niacin)
Term
PK nicotinic acid
Definition

oral

nicotinic acid->nicotinamide->NAD

Term
AE nicotinic acid
Definition

flushing (aspirin, meals, ER, low dose)

GI

liver injury

glucose intolerance

HYPERURICEMIA

Term
CI nicotinic acid
Definition

liver dysfxn

PUD

hyperuricemia (gout)

DM

Term
Fibric Acid Derivatives
Definition

Gemfibrozil

Fenofibrate

 

Term
MOA fibric acid derivatives
Definition

activate lipoprotein lipase-> delivery TG's to adipose tissue

interfere with VLDL synth is liver

HDL incr secondary synth apoprotein of HDL and incr assembly of HDL

Term

what should be monitored in pts on fibric acid derivatives

Definition

LFT's

lipids

mm s/sx

CBC's

Term
when/why should fibric acid derivatives be d/c
Definition

when lipids do not fall after 3mos

Term
fibric acid derivatives are DOC for what
Definition
increasing low HDL
Term
tx uses of fibric acid derivatives
Definition

hyper TG

incr low levels of HDL's

Term
AE fibric acid derivatives
Definition

GI

cholelithiasis

MM: myositis (worse when w/ statin)

erectile dysfxn

malignancy

Term
CI/interactions fibric acid derivatives
Definition

warfarin (competes w/ protein binding)

incr. sulfonylureas

 

Term
who should fibric acid derivatives NOT be used in
Definition

prego

liver/kidney dz

gall bladder dz

Term
cholesterol absorption inhibitors
Definition
ezetimibe
Term
MOA ezetimibe
Definition
inhibits cholesterol absorption in intestines
Term
tx uses of ezetimibe
Definition

mono tx

w/ statin

primary hypercholesterolemia

Term
how is ezetimibe metabolized
Definition
glucoronide conjugate
Term
what should you monitor in a pt on ezetimibe
Definition

LFT's

esp when combined w/ statin

Term
AE ezetimibe
Definition

tiredness

stomach pain

Supporting users have an ad free experience!