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Flashcards in hypolipidemic drugs Deck (52)
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1

Cholestin and Evolve

dietary supplements that inhibit HMGCoA reductase

almost as effective as lovastatin

2

HMG coa reductase

enzyme that controls the rate of cholesterol production

3

effects of omega 3 FA?

like fish oil
decrease LDL and TG
increase HDL

4

effects of omega 6 FA?

like veg oil
decrease LDL
BUT increases TG and decreases HDL

5

how does diet increase VLDL synthesis and secretion

excess caloric intake and not necessarily fat

6

risk factors for CHD

age
low HDL
high cholesterol
high BP
cigarettes
obesity, diabetes
history of CHD/sudden death

7

when should dietary aid be passed and go right to drugs?

if patient has 2 or more risk factors OR history of CHD death OR just diabetes

8

three bile acid binding resins
and what do they do?

cholestyramine
colestipol
colesevelam
--> lower cholesterol(especially LDL)

9

which bile acid binding resin is best to lower LDL/cholesterol?

colesevelam (less GI side effects and less interference with other drugs)

10

bile acid binding resins are used to treat:

-combined hyperlipidemia
-heterozygous familial hypercholesterolemia

11

mechanism of cholesyramine/colestipol/colesevelam

bile acid binding resin
-> binds bile acids in intestines and inhibits its reabsorption
-cholesterol is the precursor to bile acid so more cholesterol is channeled to bile
-decrease in serum cholesterol, increase in LDL receptors, clearance of lipoproteins

12

adverse effects of bile acid binding resins

reduced intrahepatic cholesterol can cause secondary cholesterol production --> constipation and bloating(fix with fiber)
--resins can bind other drugs(warfarin/anticoagulants, vitamin K, B blockers)

13

when should bile acid resins be taken?

with or just before meals
--any other drugs should be taken 2 hrs before the resins or 4 hrs after to prevent resin binding

14

are resins safe to use in pregnancy?

yes

15

what type of drug are bileacidbinding resins usually combined with?

HMGcoareductase (like lovastatin)

16

HMGcoa reductase inhibitors

any drugs that ends in -statin
(lovastatin, simvastatin)

17

what to use HMGcoareductase inhibitors for?

use statins for familial hypercholersterolemia, and combined hyperlipidemia

18

what do statins do?

they competitively inhibit HMGcoa reductase, decreasing cholesterol synthesis
causing upregulation(more ) of LDL receptors --> clearance of apoB and apoE lipoproteins (IDL, LDL, VLDL)

19

which statins reduce TG up to 40%?

simvastatin and atorvastatin

20

why are statins/reductase inhibitors usually given at night?

due to the diurnal pattern of cholesterol biosynthesis

21

side effects of statins

usually safe
-high doses plus fibric acid derivative = rhabdomyolysis and renal failure

22

can pregnant women use statins?

NEVER

23

statins and normal levels of blood cholesterol...

can reduce risk of heart attack and stroke

24

statins are excreted...

by CYP3A in the liver

25

statins drug interactions

grapefruit juice and verapamil increase serum statin [] because they inhibit CYP3A (which breaks statins down)

26

what two statins are not broken down by CYP3A (use different paths)

pravastatin and fluvastatin

27

which statin is least potent (only 3% reaches circulation as active drug) - begins as inactive drug

lovastatin

28

atorvastatin

lipitor
active drug AS GIVEN
2nd MOST EFFECTIVE STATIN at reducing LDL cholesterol and TG

29

which statin is most effective at reducing LDL cholesterol and TG? 2nd?

1- rosuvastatin
2-atorvastatin (lipitor)

30

ALL STATINS when in high doses can cause...

rhabdomyolysis