Term
| the major atherogenic lipoprotein: |
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Definition
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Term
| VLDL is a precursor for ___ which is a precursor for ___ |
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Definition
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Term
|
Definition
| hydrolyzes TG (VLDL) and chylomicrons into FFA |
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Term
| ATPIII guidelines state that lipid screening should be performed q__yrs after the age of __ |
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Definition
| every 5 yrs after the age of 20 |
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Term
| which analyte is the primary target for lipid therapy? |
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Definition
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Term
| 5 risk factors that modify LDL goals due to increased risks of atherosclerosis: |
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Definition
1. smoker
2. HTN (>140/90)or on HTN med
3. HDL<40
4. FHx prematuer HD (Males<55/fem<65)
5. Age Men>45/women>55 |
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Term
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Definition
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|
Term
| define moderately high risk for CHD: |
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Definition
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Term
| define moderate risk for CHD |
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Definition
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Term
|
Definition
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Term
| LDL goals for high, moderately highm moderate and low risk goups |
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Definition
high: <100 (<70)
moderately high <130 (<100)
moderate <130
low <160 |
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Term
| when do you initiate drug therapy in high, moderately high, moderate and low risk groups? |
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Definition
high: >130 LDL
moderately high: >130
moderate: >160
low: >190 |
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Term
| 5 dyslipidemia drug classes: |
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Definition
1. Fibric acid derivatives
2. Bile acid sequesterants
3. Cholesterol absorption inhibitors
4. Niacin
5. HMG-CoA reductase inhibitors (statins) |
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Term
| first line drug class for most patients with dyslipidemias: |
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Definition
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Term
|
Definition
| inhibit hepatic cholesterol synthesis; decreased hepatic cholesterol causes upreg of LDL receptors taking LDL out of circulation |
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Term
| statin effects LDL/HDL/TG: |
|
Definition
decrease LDL & TG
increase HDL |
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Term
|
Definition
1. rosuvastatin
2. atorvastatin |
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|
Term
| 2 major contraindications to statins: |
|
Definition
1. liver dz
2. pregnancy (class X) |
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Term
| 3 adverse effects of statins: |
|
Definition
1. muscle effects
(myopathy >>>CL=K/rhabdo)
(Myalgia no >CK)
2. liver enzyme elevation
3. drug interactions |
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|
Term
| 4 RF for Rhabdo in statin use? |
|
Definition
1. renal insufficiency
2. >65yo
3. concurrent use of fibrate or niacin
4. statin accumulation |
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Term
| which statin has the least drug interactions? |
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Definition
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Term
| 3 drugs that are of major concern for interactions with statins: |
|
Definition
1. niacin
2. fibrates
3. warfarin |
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|
Term
|
Definition
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|
Term
|
Definition
Extended release: Niaspan & Slo-niacin
Regular release: Nicor, OTC, generic |
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|
Term
|
Definition
1. LDL<25%
2. HDL>15-35%
3. TG<20-50% |
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|
Term
| 4 contraindications to niacin: |
|
Definition
1. liver dz
2. severe gout
3. PUD
4. arterial bleeding |
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Term
|
Definition
|
|
Term
| most common adverse effect of niacin: |
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Definition
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Term
| in niacin tx pretreat w ______ to decrease flushing |
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Definition
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|
Term
| dyslipidemia drug with the most BROAD effect on lipid profiles |
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Definition
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|
Term
| when switching to a long acting niacin decrease the dose by: |
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Definition
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Term
|
Definition
1. gemfibrozil
2. fenofibrate |
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Term
|
Definition
| activates LPL which decreases TG by taking VLDL to FFA. inhibits apolipoprotein C-III which inactivate LPL |
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Term
| fibrates effects on lipid profiles: |
|
Definition
|
|
Term
| 3 contraindications to fibrates: |
|
Definition
1. GB dz
2. hepatic dysfunciton
3. severe renal dysfunction |
|
|
Term
| 3 drug interactions with fibrates: |
|
Definition
1. statins
2. Ezetimibe (gallstones)
3. Gyburide & repaglinide (hypoglycemia) |
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|
Term
| 3 adverse effects of fibrates: |
|
Definition
1. gallstones
2. myopathy
3. increased LFT's |
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|
Term
| fibrates are primarily used for: |
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Definition
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|
Term
| which fibrate is approved for use with statins? |
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Definition
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|
Term
| which drug is a cholesterol absorption inhibitor: |
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Definition
|
|
Term
| ezetimibe effects on lipid profile: |
|
Definition
|
|
Term
| contraindications to ezetimibe use: |
|
Definition
1. active liver dz (when used w a statin)
2. hypersensativity |
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|
Term
| ezetimibe drug interactions: 2 |
|
Definition
1. cyclosporins (increase both)
2. fibrates |
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|
Term
| Ezetimibe required monitoring: |
|
Definition
| LFT's if on a statin, no monitoring req if used as monotherapy |
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|
Term
| Ezetimibe is complementary to which drugs? |
|
Definition
| those that impact cholesterol synthesis |
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|
Term
| 3 bile acid sequeserants: |
|
Definition
1. cholestyramine
2. colesevelam
3. colestipol |
|
|
Term
| bile acid sequesterants MOA: |
|
Definition
| inhibit ileum/jejunum reuptake of bile acids for recycling; causes liver to take up new LDL for bile synthesis |
|
|
Term
| bile acid sequesterants effects on LDL,HDL,TG |
|
Definition
LDL: <15-30%
HDL: >3-5%
TG: >0-10% (yes increase) |
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Term
| 2 contraindications for BAS: |
|
Definition
1. bowel obstruciton
2. complete biliary obstruction |
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Term
| 3 adverse effects of BAS: |
|
Definition
1. GI - consitpation/fart/bloat
2. steatorrhea
3. malabsorption of fat/VitADEK |
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Term
| which is the prefered BAS: |
|
Definition
|
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Term
|
Definition
| not regularly used, better drugs avail |
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