Pharmacology and Pharmoctherapy of Lipid Drugs and Disorders Flashcards

1
Q

Uncontrolled hyperlipidemia significantly increases risk of what coronary heart diseases

A

Coronary artery disease, cerebovascular disease, peripheral vascular disease

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2
Q

What are non-modifiable cardiovascular risk factors

A

Increased age, male sex, first degree relative family history, Race

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3
Q

What are modifiable cardiovascular risk factors

A

Cigarette smoking, hypertension, obesity, diabetes, physical inavtivity, high LDL, poor diet

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4
Q

T/F: Lipid panels should start being done at 20

A

True

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5
Q

T/F: LDL is calculated and cannot be calculated if triglyceride levels are greater than 300

A

False: LDL is calculated and cannot be calculated if triglyceride levels are greater than 400

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6
Q

What is optimal LDL levels, high LDL levels, very high LDL levels

A

less than 100, 160-189, greater than 190

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7
Q

What is a high level for HDL

A

greater than 160

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8
Q

What is a very high reading for serum triglycerides

A

Greater than 500

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9
Q

What are the ASCVD risk groups

A

Clinical ASCVD, Severe hypercholesterolemia, Diabetes, Primary Prevention

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10
Q

What is primary prevention

A

Therapy aimed to prevent first ASCVD event

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11
Q

What is secondary prevention

A

Therapy aimed to prevent a subsequent event

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12
Q

T/F: Patients who are part of the secondary prevention are considered to have clinical ASCVD

A

True

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13
Q

What is ASCVD

A

Atherosclerotic cardiovascular disease

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14
Q

History of what diseases would make someone be diagnosed with ASCVD

A

Myocardial Infarction, Stable or unstable angina, Coronary or other aterial vascularization

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15
Q

What current diseases would a patient have in order to be diagnosed with ASCVD

A

Acute coronary syndrome, Stroke or transient ischemic attack, peripheral arterial disease

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16
Q

What are secondary causes of dyslipidemia

A

Medication-related, uncontrolled diabetes mellitus, alcohol, malnutrition, liver disease

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17
Q

What are the two determinants on if a patient is considerd high-risk for future ASCVD events if they are in the Clinical ASCVD group

A

History of multiple major ASCVD events, 1 major event and multiple high-risk conditions

18
Q

What are major ASCVD events

A

Recent Acute coronary syndrome, history of myocardial infarction, history of ischemic stroke, symptomatic peripheral arterial disease

19
Q

What are high risk conditions for ASCVD events

A

Age greater than 65, diabetes mellitus, hypertension, CKD (eGFR 15-59ml/min/1.73m2), current smoking, persistent LDL-C elevation (greater than 101) despite max statin and ezetimibe , history of congestive heart failure

20
Q

T/F: If someone is in the Clinical ASCVD group they should be assessed to either be on a high intensity statin or a low intentisty statin

A

False: Everyone in the Clinical ASCVD group should be on a high intensity statin whether very high risk or not

21
Q

If a patient is in the clinical ASCVD group and is on a max tolerated statin with LDL greater than 70 what medication would it be reasonable to add

A

Ezetimibe

22
Q

If a patient is in the clinical ASCVD group an is very high risk, on a statin, and on ezetimibe and their LDL is greater than 70 what medication would it be reasonable to add

A

PCSK9 inhibitor

23
Q

What is a baseline LDL for someone in the severe hypercholesterolemia group

A

Baseline LDL greater than 190 mg/dL

24
Q

T/F: Patients in the severe hypercholesterolemia group have high lifetime ASCVD risk

A

True

25
Q

What medication should all severe hypercholesterolemia patients be on

A

Maximally tolerated statin

26
Q

When is adding ezetimibe reasonable for a patient who is in the severe hypercholesterolemia group

A

There is a less than 50% reduction in LDL with statin

27
Q

When is adding a PCSK9 reasonable for a patient who is in the severe hypercholesterolemia group

A

If the patient is on a statin and ezetimibe with LDL greater than 130 mg/dL

28
Q

When a patient is in the diabetes group what is their risk of ASCVD events

A

Intermediate to high-risk

29
Q

What is medication is required if a patient is in the diabetes group

A

At least a moderate intensity statin

30
Q

When would it be appropriate to give someone a high intensity statin if the patient is in the diabetes group

A

If the patient has multiple ASCVD risk factors or risk modifiers

31
Q

What are the diabetic specfic risk modifiers

A

DM1 greater than 20 years or DM2 greater than 10 years, Albuminuria, eGFR less than 60ml/min/1.73m2, retinopathy, neuropathy, ankle brachial index less than 0.9

32
Q

When would it be reasonable to add ezetimibe to statin therapy for a patient in the diabetes group

A

ASCVD risk is greater than 20%

33
Q

What is the goal LDL reduction for patients in the diabetic group

A

Reduce LDL by 50%

34
Q

If a patient is in the primary prevention risk and has an ASCVD risk of of less than 5% (low risk) what is the therapy

A

Lifestyle changes only

35
Q

If a patient is in the primary prevention risk and has an ASCVD risk of 5% to 7% (borderline risk) what is the therapy

A

Lifestyle changes, consider a moderate intensity statin if risk enhancers are present

36
Q

If a patient is in the primary prevention risk and has an ASCVD risk 7.5% to 20% (intermediate risk) what is the therapy

A

Lifestyle changes, moderate intensity statin if risk enhancers are present

37
Q

T/F: Patients in the primary prevention with intermediate risk can be considered for a hgih intesnsity statin and addition of ezetimibe if the high intensity statin is not tolerated

A

True

38
Q

If a patient is in the primary prevention risk and has an ASCVD risk greater than or equal to 20% (high risk) what is the risk

A

Lifestyle changes and a high intensity statin

39
Q

What is the goal for patients in the primary prevention group with intermediate risk, high risk

A

30% to 49%, 50%

40
Q

What are the risk enhancers for patients in the primary prevention group

A

Persistently elevated LDL greater than 160 mg/dl, persistently elevated triglycerides greater than 175 mg/dl, metabolic syndrome