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MJ- Pharm exam 2 > Dyslipidemia 3 > Flashcards

Dyslipidemia 3 Flashcards

1
Q

What inhibits PCSK9?

A

MAB - Monoclonal Antibodies

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2
Q

What is a side effect of MAB inhibitors PCSK9?

A

Influenza

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3
Q

Alirocumab or Evolocumab?

  • SQ 75 mg once every 2 weeks
  • SQ 140 mg every 2 weeks or 420 mg once monthly
A
  • Alirocumab = 75mg
  • Evolocumab = 140/420
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4
Q

Who would you give a monthly dose of Evolocumab to 420mg?

A

Adolescents

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5
Q
  • What is an MTP inhibitor?
  • What is the name of one?
A
  • Microsomal Triglyceride Transfer Protein Inhibitor
  • Juxtapid (Lomitapide)
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6
Q

Which drug?

Mechanism:

  • Binds directly to and inhibits MTP
  • **Prevents assembly of apo-B containing lipoproteins
  • **Reduced production of chylomicrons and VLDL
  • Reduced plasma LDL concentrations
A

Juxtapid (lomitapide) - MTP inhibitor

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7
Q

What is the indication for giving an MTP inhibitor: Juxtapid (lomitapide)?

A

Homozygous familial hypercholesterolemia

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8
Q

What is the major side effect of MTP inhibitor: Juxtapid (lomitapide)?

A
  • Diarrhea (79%)
    • increases hepatic fat (hepatic steatosis) with or without concomitant increases in transaminases
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9
Q

2 contraindications of MTP inhibitor : Juxtapid (lomitapide)?

A
  • Pregnancy (teratogenic)
  • Hepatic impairment or active hepatic disease
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10
Q

Which drug?

Drug interactions:

  • substrate of CYP3A4
  • Inhibits CYP3A4 and P-glycoprotein
A

Lomitapide (MTP inhibitor)

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11
Q
  • Lomitapide increases the levels of what?
  • Lomitapide levels are decreased with what?
A
  • Lovastatin
  • BAS (Bile acid sequestrant)
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12
Q
  • **What is the “Boxed Warning” of Lomitapide?**
  • What is the name of the program?
A
  • Hepatotoxicity
  • JUXTAPID REMS PROGRAM
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13
Q

What can a patient taking Lomitapide do to avoid GI effects (diarrhea)?

A

Low fat diet <20%

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14
Q

Which drug?

MOA:

  • Inhibitor of apolipoprotein B-100 synthesis
  • Adjunct to lipid-lowering medications and deit to reduce low LDL, apo B, TC, and non HDL
A

Mipomersen sodium (Kynamro)

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15
Q

Indication to give Mipomersen sodium (Kynamro)?

A

Homozygous familial hypercholesterolemia (HoFH)

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16
Q

How is Mipomersen sodium (Kynamro) administered and how often?

A
  • SQ (subcutaneously)
  • Weekly
17
Q

ADE/ADR of Miopmersen sodium (Kynamro)

  • 84% experience what?
  • 30% experience what?
A
  • Injection site rxn
  • Flu-like sxs 2 days after injection
18
Q

Contraindication of Mipomersen sodium (Kynamro)

A

Moderate/Severe hepatic impairment or active liver disease

19
Q

BOXED WARNING of Mipomersen sodium (Kynamro)

A

Hepatotoxicity

20
Q

What 2 baseline labs should you monitor if pt is on Mipomersen sodium (Kynamro)?

A
  • ALT (alanine aminotransferase)
  • AST (aspartate transaminase)
21
Q

What is the restricted program called for boxed warning of Mipomersen sodium (Kynamro)?

A

KYNAMRO REMS

22
Q

Which drug?

MOA:

  • Upregulates lipoprotein lipase (LPL)
    • Increases catabolism of VLDL
    • Elimination of TG-rich particles
    • Fatty acid oxidation
  • Modulation of apolipoprteins
    • Decreases apolipoprotein CIII by enhancing catabolism and clearance of TG-rich particles
A

Fibrates

23
Q

Which drug?

  • Primary effect on TGs (lowers 35-50%)
  • Decreases LDLs (5-20%)
  • LDLs may increase in pts w/ elevated TGs
  • Increase HDL (5-20%) w/ greater increase in severe hypertriglyceridemia
A

Fibrates

24
Q
  • The names of the 3 main fibrates
  • Which one is important?******
A
  • Fenofibrate
  • Fenofibric acid
  • _*****Gemfibrozil******_
25
Q

SE of which drug?

  • ****Increase LFTs (dose related)
  • abd pain, HA
  • *****Cholelithiasis
A

Fibrates (Fenofibrate, Gemfibrozil)

26
Q

4 contraindications of Fibrates, which one is most important?

A
  • Hepatic dysfunction
  • ***Severe renal impairment (CrCl <30 ml/min)***
  • Pre-existing gallbladder disease
  • Breast-feeding
27
Q

What 3 things should you monitor in pt taking Fibrates?

A
  • LFTs (liver function tests)
  • Renal function
  • Lipid panel
28
Q

Which drug?

Drug interactions:

  • Statins* (increases risk of myopathies)
  • Sulfonylureas (may enhance hypoglycemic effects)
  • Warfarin (may enhance anticoagulant effect, so monitor INR)
A

Fibrates

29
Q

Nicotinic Acid is NOT called what??

A

Nicotinamide

MJ- Pharm exam 2 (19 decks)

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