Chapters on Hyperlipoproteinemia and Lipid Drugs
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Questions and Answers

Qual classification de hyperlipoproteinemia es characterisate per un elevation significante de chylomicrones?

  • Hyperchylomicronemia familial (correct)
  • Hypertriglyceridemia familial
  • Hypercholesterolemia familial
  • Hyperlipidemia combinate
  • Qual del sequente medicamentos es un inhibitor de HMG-CoA reductasa (statina)?

  • Gemfibrozil
  • Lovastatina (correct)
  • Niacina
  • Cholestyramina
  • Qual lipoproteina primarimente es elevate in le hypertriglyceridemia familial?

  • LDL (Lipoproteinas de basse densitate)
  • IDL (Lipoproteinas de densitate intermediari)
  • VLDL (Lipoproteinas de trasse basse densitate) (correct)
  • HDL (Lipoproteinas de alte densitate)
  • Qual del sequente agentes es un resina que liga le acidos biliari?

    <p>Colesevelam (D)</p> Signup and view all the answers

    Qual del sequente conditiones es characterisate per un nivello elevate a tanto VLDL como LDL?

    <p>Hyperlipidemia Combinate (A)</p> Signup and view all the answers

    Qual del sequente es un effecto primari de ezetimibe super lipidos plasmatic?

    <p>Reduction de LDL plasmatic (A)</p> Signup and view all the answers

    Qual es un effecto secundari potential associate con le uso de ezetimibe?

    <p>Debilitate muscular (A)</p> Signup and view all the answers

    In qual conditiones es ezetimibe contraindicate?

    <p>Maladia hepatic active (B)</p> Signup and view all the answers

    Qual es le mechanismo de action de ezetimibe?

    <p>Inhibition selective del absorption intestinal de cholesterol dietari e phytosterol (C)</p> Signup and view all the answers

    Quando debe ezetimibe esser usate con precaution durante le pregnantia?

    <p>Quando le beneficios excede le risco potential al feto (D)</p> Signup and view all the answers

    Qual condition es un contraindication pro le uso de acido nicotinic?

    <p>Graviditate (A)</p> Signup and view all the answers

    Qual es le mechanismo de action primari de niacina (acido nicotinic) in le reduction del lipides plasmatic?

    <p>Inhibir le lipolyse in texitos peripheric (B)</p> Signup and view all the answers

    Qual effecto adverse de niacina pote esser alleviate per le administration de aspirina?

    <p>Rubor cutanee e prurito (B)</p> Signup and view all the answers

    Qual es le mechanismo de action de PCSK9 inhibidores?

    <p>Augmenta le numero de receptores LDL disponibile per inhibir PCSK9 que normalmente se liga a illos. (C)</p> Signup and view all the answers

    Qual es un effecto therapeutic de niacina (acido nicotinic) super lipides plasmatic?

    <p>Reducir le nivellos de LDL (D)</p> Signup and view all the answers

    Qual effecto ha PCSK9 inhibidores typicamente super le lipidos plasmatic?

    <p>Reduction in LDL e un augmento moderate in HDL (C)</p> Signup and view all the answers

    Qual es le ration pro le qual statinas (excepto atorvastatina e rosuvastatina) debe esser administrate in le vespere?

    <p>Pro que le biosynthese de cholesterol occurre principalmente de nocte (A)</p> Signup and view all the answers

    Qual droga inter le sequente es un prodroga que debe esser hydrolysate in le hepate pro converter se in su forma active?

    <p>Simvastatina (C)</p> Signup and view all the answers

    Qual es un effecto secundari communmente reportate associate con le uso de PCSK9 inhibidores?

    <p>Reactiones al sito de injection (D)</p> Signup and view all the answers

    Qual es le effecto primari del fibratos super le lipidos plasmatic?

    <p>Stimular le oxidation de acidos grasse via PPAR-α. (D)</p> Signup and view all the answers

    In qual condition clinic es le uso de PCSK9 inhibidores generalmente considerate?

    <p>Hypercholesterolemia familial (C)</p> Signup and view all the answers

    Qual condition require precaution quando prescribe niacina a causa del risco de exacerbar iste condition?

    <p>Diabete Mellitus (A)</p> Signup and view all the answers

    Qual es le ration pro le contraindication de HMG-CoA reductase in graviditate?

    <p>Pro que es essential pro le disveloppamento del feto/infante (C)</p> Signup and view all the answers

    Pro que le graviditate es generalmente considerate un contraindication relative pro le uso de PCSK9 inhibidores?

    <p>Il ha datos de securitate limitate e potential risco de damno al feto. (C)</p> Signup and view all the answers

    Qual es un effecto secundari communmente associate con le uso de fibratos?

    <p>Cholelithiasis (calculos in le vesicula biliari). (A)</p> Signup and view all the answers

    Qual es le mechanismo de action del fibratos sur le lipoproteinas?

    <p>Activation de PPARα pro reducer le synthese hepatic e secretion de VLDL. (A)</p> Signup and view all the answers

    In qual condition clinic le fibratos es considerate le droga de election?

    <p>Hypertriglyceridemia sever. (D)</p> Signup and view all the answers

    Qual es un contraindication major pro le uso de fibratos?

    <p>Insufficientia renal. (C)</p> Signup and view all the answers

    Qual es le effecto del fibratos super le lipoproteina HDL?

    <p>Augmentar le nivellos de HDL per 10-25%. (B)</p> Signup and view all the answers

    Qual es le ration pro que le fibratos es contraindicate durante le graviditate?

    <p>Illos ha monstrate effectos embryocidal e teratogenic in animales experimental. (C)</p> Signup and view all the answers

    Qual es un differentia importante inter le fibratos de prime e secunde generation?

    <p>Le fibratos de secunde generation reduce le LDL plasmatic plus efficacemente. (D)</p> Signup and view all the answers

    Qual combination de medicamentos es plus probabilemente usate pro patientes con LDL severmente elevate e demonstration de pauc toxicitate?

    <p>Resinas, acido nicotinic, e statins (A)</p> Signup and view all the answers

    Qual effecto combinate es expectate quando statins e PCSK9i es usate simultaneemente?

    <p>Reduction marcate de LDL (A)</p> Signup and view all the answers

    In qual situation clinic es le combination de acido bempedoic e statin le plus frequentemente prescribite?

    <p>Quando statins solmente es insufficiente. (C)</p> Signup and view all the answers

    Qual droga es le plus probabile causa de flushing e prurit post dosage, alleviate per aspirina?

    <p>Niacina (C)</p> Signup and view all the answers

    Un patiente con morbo coronari recipe un droga que reduce LDL, triglyceridos, e lipoproteina (a), e augmenta HDL. Qual droga es le plus probabile?

    <p>Niacina (D)</p> Signup and view all the answers

    Un patiente reporta constipation e sufflation post initiar un medication pro hyperlipidemia. Qual droga es le plus probabile causa?

    <p>Cholestyramina (D)</p> Signup and view all the answers

    Qual es le mechanismo primari de action de un droga que reduce niveles de trigliceridos per augmentar le activitate de lipoproteina lipasa?

    <p>Augmentation de activitate de lipoproteina lipasa (B)</p> Signup and view all the answers

    Qual es le rationamento pro reducer le doses individual de agentes antihyperlipidemic in combination therapia?

    <p>Maximisar le effectos additive durante que diminui le risiko de effectos adverse (C)</p> Signup and view all the answers

    Flashcards

    Familial hyperchylomicronemia

    A condition characterized by very high levels of chylomicrons, triglycerides (TG), and cholesterol.

    HMG-CoA reductase inhibitors

    A class of drugs, known as statins, used to lower LDL cholesterol levels.

    Dysbetalipoproteinemia

    A disorder associated with increased levels of VLDL and IDL, leading to high cholesterol levels.

    Fibrates

    A group of drugs that primarily lower triglycerides and improve HDL cholesterol levels.

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    Familial hypercholesterolemia

    A genetic disorder that causes very high levels of LDL cholesterol.

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    Contraindication

    Conditions where a drug should not be used, e.g., in pregnancy or nursing.

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    HMG-CoA reductase

    An enzyme involved in cholesterol synthesis, crucial during pregnancy.

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    Drug Interactions

    Certain medications can increase the risk of side effects when taken together.

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    Statins Administration

    Most statins should be taken in the evening for effectiveness.

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    Lovastatin and Simvastatin

    Inactive prodrugs that become active in the liver after metabolism.

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    Niacin (Vitamin B3)

    A vitamin that lowers LDL and triglycerides; taken orally.

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    Side Effects of Niacin

    Common side effects include flushing, gastrointestinal upset, and hepatotoxicity.

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    Clinical Indications for Niacin

    Used to treat hypercholesterolemia, hypertriglyceridemia, and hyperlipidemia.

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    Mechanism of action

    Inhibits intestinal absorption of dietary cholesterol and phytosterols.

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    Effects on plasma lipid

    Reduces Plasma TC and LDL, increases HDL minimally.

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    Side effects

    Low incidence of hepatic impairment, muscle weakness, pancreatitis.

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    Clinical indications

    Used for hypercholesterolemia, phytosterolemia, and in children with familial hypercholesterolemia.

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    Inhibitor

    Un substancia que impedi un processu chimic.

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    PPARα

    Recettor activator pro oxidazione de acidos grasos.

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    Hypertriglyceridemia

    Niveles elevatos de trigliceridos en sangu.

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    Cholelithiasis

    Forma de calculos biliaires in vesicula biliare.

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    PCSK9

    An enzyme that binds to LDL receptors to prevent LDL removal from blood.

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    PCSK9 Inhibitors

    Drugs that increase LDL receptor availability, reducing LDL levels in the blood.

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    Effects on Plasma LDL

    PCSK9 inhibitors lower plasma LDL by 50-60%.

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    Clinical Indications for PCSK9 Inhibitors

    Used in familial hypercholesterolemia, CVD with high LDL, and statin intolerance.

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    Side Effects of PCSK9 Inhibitors

    Common side effects include injection site reactions, flu-like symptoms, and headaches.

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    Statins

    Drugs that reduce cholesterol production in the liver.

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    Bempedoic acid

    A drug used when statins alone are insufficient for LDL reduction.

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    Cholestyramine

    A resin that lowers LDL cholesterol with minimal toxicity.

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    Ezetimibe

    A medication that decreases cholesterol absorption in the intestines.

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    Niacin Side Effects

    Flushing and itchiness relieved by aspirin after taking niacin.

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    Gemfibrozil

    A drug that increases lipoprotein lipase activity to lower triglycerides.

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    Combination Therapy

    Using multiple agents like statins and PCSK9i to lower LDL further.

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    Study Notes

    Antihyperlipidaemia Drugs

    • HMG-CoA Reductase Inhibitors (Statins):

      • Inhibit HMG-CoA reductase, the rate-limiting step in cholesterol biosynthesis.
      • Decrease cholesterol synthesis and increase LDL receptor activity.
      • Examples include lovastatin, simvastatin, atorvastatin.
      • Reduce LDL cholesterol.
      • Often used as a first-line treatment.
      • May cause muscle pain (myopathy).
    • Fibric Acids:

      • Lipid-lowering agents, reducing VLDL and TG levels.
      • May upregulate lipoprotein lipase activity.
      • Examples include clofibrate, gemfibrozil, fenofibrate.
      • Increase HDL cholesterol.
      • Potential for adverse effects, including gallstones and muscle pain.
    • Nicotinic Acid (Niacin):

      • Inhibits lipolysis in peripheral tissues, reducing VLDL secretion.
      • Increases HDL level.
      • Often causes cutaneous flush (prostaglandin mediated).
      • May increase blood uric acid.
    • Bile Acid Binding Resins:

      • Bind bile acids in the small intestine, preventing their enterohepatic circulation.
      • Force the liver to produce more bile acids from cholesterol, increasing cholesterol uptake.
      • Reduce LDL cholesterol.
      • May cause constipation, bloating, and nausea.
    • Intestinal Sterol Absorption Inhibitors:

      • Ezetimibe.
      • Selectively inhibits intestinal absorption of cholesterol and phytosterols.
      • Reduces cholesterol absorption.
      • Decreases plasma LDL concentration
      • May cause muscle weakness or mild liver dysfunction.
    • PCSK9 Inhibitors:

      • Evolucumab, Alirocumab.
      • Prevent PCSK9 (an enzyme) binding to LDL receptors, increasing LDL receptor activity.
      • Significant reduction in LDL cholesterol.
    • ATP-Citrate Lyase Inhibitors:

      • Bempedoic acid.
      • Inhibits ATP-citrate lyase, an important enzyme in fatty acid biosynthesis.
      • Reduces cholesterol synthesis.
      • Reduces LDL cholesterol.
      • May affect muscle functions.
    • Cholesteryl Ester Transfer Protein (CETP) Inhibitors:

      • Torcetrapib, Anacetrapib, Dalcetrapib.
      • Inhibit CETP, reduce LDL cholesterol, and increase HDL cholesterol.
      • Associated with increased cardiovascular events leading to removal from the market.

    Drug Combinations

    • Combination therapies often increase efficacy and reduce side effects, compared to single drug treatments.

    Hyperlipidemia Classifications

    • Diseases characterized by elevated blood lipid levels.
    • Classified by the specific lipoprotein abnormalities (e.g., familial hyperchylomicronemia, familial hypercholesterolemia).
    • Specific disorders demonstrate elevated levels of various lipoproteins.

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