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Cholesterol meds

Mod 4, Pharm

QuestionAnswer
What two conditions are a result of hyperlipidemia? pancreatitis atherosclerosis
What is the leading cause of death for both sexes in the US and other western countries? Atherosclerosis
What type of lipoprotein transport lipids into arterial walls? apolipoprotein B100
When does cholesterol biosynthesis occur? at night
When is the usual time to give cholesterol medication? in the evening since that is when the body makes cholesterol (except atorvastatin)
Name the 4 types of medication used to treat hyperlipidemia. 1. competitive inhibitors of HMG-CoA Reductase 2. Niacin 3. Fibric acid derivatives 4. bile-acid binding resins
What is another name for competitive inhibitors of HMG-CoA Reductase? Statins
How does HMG-CoA reductase reduce cholesterol? mediates the biosynthesis of mevalonate-a precursor to cholesterol which impairs synthesis of cholesterol
What are two significant clinical considerations of statins? 1. liver function 2. muscle weakness (r/t rhabdomyolysis)
Name two statins 1. atorvastatin (Lipitor) 2. simvastatin (Zocor)
Can any statins be given to pregnant or lactacting women? NO, pregnancy class X Not prescribe even if they could become pregnant
What was the second highest prescription in US in 2004? Lipitor (atorvastatin) over 69million Rx
Which statin has a long half-life? atorvastatin (Lipitor) at 14 hours
What is the route and dose of atorvastatin? 10mg po daily (may increase to 80mg) Only available po Dose based on lipid level drawn within 2-4 wks after starting therapy
What is the plasma half-life of simvastatin? 1-3 hours Dose in evening due to short half-life
Name dosage of simvastatin. 5-10mg po in evening adjust dose every 4 wks based on patient tolerance and response Max dose 40mg (20mg in geriatric)
What medications increase levels of statins and increase adverse reactions to HMG-CoA reductase inhibitors? Macrolides (Erythromycin and Clarithromycin) Grapefruit
What adverse reactions are possible with increased levels of HMG-CoA reductase inhibitors? myopathy rhabdomyolysis acute renal failure
What are expected lipid level changes when a patient takes Niacin? < VLDL, < LDL, < Lp(a) > HDL
Niacin inhibits what lipid secretion? VLDL
What is the pregnancy risk category for Niacin at the recommended dose to reduce lipids? C
Niacin RDA is _________ and the dose to reduce triglycerides is__________. RDA: 19mg (men); 15mg (women) Triglyceride reducing dose: 1.5-6 grams
What is the maximum daily dose of Niacin. 9 grams
How is Niacin dosed? 1.5-6 grams in 2-4 divided doses with or after meals
What class is gemfibrozil? fibric acid derivative
What is the name brand of gemfibrozil? Lopid
What is the dosage of gemfibrozil? 600mg BID 30 min before morning and evening meals
What is expected lipid level changes when taking gemfibrozil? < VLDL, possible < LDL
What is the mechanism of action of gemfibrozil? increased lipolysis of lipoprotein triglycerides
What drug interactions should be monitored with gemfibrozil? Warfarin (increase warfarin levels) Statins (increase risk of myopathy & rhabdo.)
what is the pregnancy risk class of gemfibrozil? C
Name a bile acid-binding resin? cholestyramine
What is the name brand of cholestyramine? Questran
How does cholestyramine reduce lipids? Prevents reabsorption of bile acids and cholesterol metabolites in jejunum or ileum 10-fold
What is the dosage of cholestyramine? 4 grams po ac & hs (may be given 1-6 divided doses to reduce SE) Max dose 32 grams
What are adverse effects of cholestyramine? constipation, fecal impaction
Created by: Tabble
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