Drugs for Hyperlipidemia
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Questions and Answers

What type of cholesterol is primarily considered 'bad cholesterol' and is correlated with coronary heart disease?

  • Cholesterol absorption inhibitors
  • Low-density lipoprotein (LDL-C) (correct)
  • High-density lipoprotein (HDL-C)
  • Triglycerides

    • Which of the following is NOT classified as an antihyperlipidemic drug?

  • Fibrates
  • Beta-blockers (correct)
  • Omega-3 fatty acids
  • HMG CoA reductase inhibitors (statins)

    • What lifestyle factor can contribute to elevated cholesterol levels according to the overview provided?

  • Mediterranean diet
  • Excess saturated fat in diet (correct)
  • Regular physical activity
  • Low carbohydrate intake

    • Statin therapy is primarily recommended for which of the following conditions?

    <p>Hypercholesterolemia</p> Signup and view all the answers

    Which of the following drugs is an example of a fibrate used for treating hyperlipidemia?

    <p>Gemfibrozil</p> Signup and view all the answers

    What is the recommended effect of lifestyle changes when combined with drug therapy for lipid control?

    <p>A 30-40% reduction in CHD mortality</p> Signup and view all the answers

    Elevated triglycerides are primarily linked to which of the following health conditions?

    <p>Coronary heart disease</p> Signup and view all the answers

    Which of the following treatments is suggested for managing hypertriglyceridemia?

    <p>Diet and exercise</p> Signup and view all the answers

    What is the primary reason patients who are homozygous for familial hypercholesterolemia benefit less from certain cholesterol treatments?

    <p>They lack LDL receptors.</p> Signup and view all the answers

    What is the absorption rate of statins following oral administration?

    <p>Variable at 30-85%</p> Signup and view all the answers

    What adverse effect related to liver function should be monitored before and during statin therapy?

    <p>Elevated liver enzymes.</p> Signup and view all the answers

    Which condition may increase the risk of rhabdomyolysis in patients taking simvastatin?

    <p>Renal insufficiency.</p> Signup and view all the answers

    What is the typical dose range of niacin for lowering triglycerides?

    <p>1.5-3 g/d.</p> Signup and view all the answers

    How does niacin primarily reduce LDL-C levels?

    <p>By inhibiting lipolysis in adipose tissue.</p> Signup and view all the answers

    Which enzyme metabolizes simvastatin, increasing the risk of interactions when inhibited?

    <p>Cytochrome P450 3A4.</p> Signup and view all the answers

    What is a common side effect of statins that may necessitate monitoring plasma creatine kinase levels?

    <p>Myopathy.</p> Signup and view all the answers

    What is a primary therapeutic use of niacin?

    <p>Treating familial hyperlipidemias</p> Signup and view all the answers

    How is niacin processed in the body after oral administration?

    <p>It is converted to nicotinamide</p> Signup and view all the answers

    What side effect is commonly associated with niacin use?

    <p>Intense cutaneous flush</p> Signup and view all the answers

    Which of the following statements is true regarding the use of aspirin with niacin?

    <p>Aspirin prevents cutaneous flushing</p> Signup and view all the answers

    Which of the following is a mechanism of action for fibrates?

    <p>Activation of peroxisome proliferator activated receptors (PPARs)</p> Signup and view all the answers

    Which of the following is true about fenofibrate compared to gemfibrozil?

    <p>Fenofibrate is more effective than gemfibrozil in lowering triglyceride levels</p> Signup and view all the answers

    What effect does niacin have on uric acid levels?

    <p>It inhibits tubular secretion of uric acid</p> Signup and view all the answers

    What potential risk is associated with the use of niacin in patients with hepatic disease?

    <p>Hepatotoxicity</p> Signup and view all the answers

    Which drugs are primarily effective in lowering triglyceride levels?

    <p>Niacin and fibric acid derivatives</p> Signup and view all the answers

    What is the primary benefit of statins in hyperlipidemia treatment?

    <p>Reduction of LDL-C</p> Signup and view all the answers

    Which of the following statins is considered the most potent in lowering LDL cholesterol?

    <p>Pitavastatin</p> Signup and view all the answers

    How do HMG CoA reductase inhibitors primarily decrease LDL cholesterol levels?

    <p>By inhibiting cholesterol synthesis and increasing LDL receptor numbers</p> Signup and view all the answers

    Which statement about the therapeutic uses of statins is accurate?

    <p>They lower cholesterol levels in all types of hyperlipidemias.</p> Signup and view all the answers

    Which of these drugs is known for a secondary benefit of triglyceride reduction?

    <p>Atorvastatin</p> Signup and view all the answers

    Which of the following is NOT a mechanism by which statins exert their therapeutic effects?

    <p>Inhibition of diastolic blood pressure</p> Signup and view all the answers

    What is the mechanism behind the increased LDL receptor numbers when using statins?

    <p>Decreased intracellular cholesterol levels</p> Signup and view all the answers

    What is the primary therapeutic use of fibrates?

    <p>Treating hypertriglyceridemias</p> Signup and view all the answers

    What is the primary effect of bile acid binding resins on cholesterol metabolism?

    <p>They enhance the conversion of cholesterol to bile acids.</p> Signup and view all the answers

    Which of the following is a common adverse effect of fibrates?

    <p>Mild gastrointestinal disturbances</p> Signup and view all the answers

    Which conditions are indicated for the use of bile acid binding resins?

    <p>Type IIA and type IIB hyperlipidemias</p> Signup and view all the answers

    What is the fate of fenofibrate after oral administration?

    <p>It is converted to fenofibric acid, the active moiety</p> Signup and view all the answers

    Which condition is a contraindication for fibrates?

    <p>Severe hepatic dysfunction</p> Signup and view all the answers

    What is a common adverse effect associated with bile acid sequestrants?

    <p>GI disturbances such as constipation</p> Signup and view all the answers

    What effect do fibrates have on HDL cholesterol levels?

    <p>They increase HDL cholesterol levels</p> Signup and view all the answers

    How do bile acid binding resins affect the absorption of other drugs?

    <p>They impair the absorption of many drugs.</p> Signup and view all the answers

    Which of the following statements about colesevelam is true?

    <p>It is used for glucose-lowering effects in type 2 diabetes.</p> Signup and view all the answers

    Which substance is primarily responsible for the formation of glucuronide conjugates during the metabolism of fibrates?

    <p>Fenofibric acid</p> Signup and view all the answers

    What is the mechanism of action of ezetimibe?

    <p>It inhibits the absorption of dietary and biliary cholesterol.</p> Signup and view all the answers

    What is the mechanism of action of bile acid sequestrants?

    <p>They bind negatively charged bile acids in the intestine</p> Signup and view all the answers

    What should be monitored more frequently when a patient is taking both gemfibrozil and warfarin?

    <p>INR (International Normalized Ratio)</p> Signup and view all the answers

    What is the ideal time to take other medications in relation to bile acid binding resins?

    <p>1 to 2 hours before or 4 to 6 hours after</p> Signup and view all the answers

    What is a contraindication for the use of bile acid sequestrants?

    <p>Significant hypertriglyceridemia over 400 mg/dL</p> Signup and view all the answers

    Study Notes

    Drugs for Hyperlipidemia

    • Coronary heart disease (CHD) is the leading cause of death worldwide, correlated with high levels of low-density lipoprotein cholesterol (LDL-C), triglycerides, and low levels of high-density lipoprotein cholesterol (HDL-C).
    • Other risk factors for CHD include smoking, hypertension, obesity, and diabetes.
    • Elevated cholesterol levels can be caused by lifestyle factors, such as a lack of exercise or a diet high in saturated fats.
    • Hyperlipidemias can also result from a combination of genetic and lifestyle factors.
    • Appropriate lifestyle changes, along with drug therapy, can lead to a 30-40% reduction in CHD mortality.
    • Antihyperlipidemic drugs are often taken indefinitely to control plasma lipid levels.

    Types of Drugs for Hyperlipidemia

    • HMG CoA Reductase Inhibitors (Statins): Lower LDL-C, reducing coronary events and death from CHD.
      • Atorvastatin (Lipitor)
      • Fluvastatin (Lescol)
      • Lovastatin (Mevacor)
      • Pitavastatin (Livalo)
      • Pravastatin (Pravachol)
      • Rosuvastatin (Crestor)
      • Simvastatin (Zocor)
    • Fibrates: Lower triglycerides and increase HDL levels.
      • Gemfibrozil
      • Fenofibrate
    • Niacin: Reduces LDL-C, increases HDL-C, and lowers triglycerides.
    • Cholesterol Absorption Inhibitors: Selectively inhibit cholesterol absorption
      • Ezetimibe (Zetia)
    • Bile Acid Sequestrants: Bind bile acids, lowering LDL-C.
      • Colesevelam (Welchol)
      • Colestipol (Colestid)
      • Cholestyramine (Questran, Prevalite)
    • Omega-3 Fatty Acids: Lower triglycerides.
      • Docosahexaenoic and eicosapentaenoic acids (Lovaza)
      • Icosapent ethyl (Vascepa)

    Mechanism of Action and Therapeutic Uses

    • Drugs work through various mechanisms to lower cholesterol, including inhibiting cholesterol synthesis, increasing LDL receptors, and affecting triglyceride production.
    • These drugs are used to treat a variety of hyperlipidemias, types I, IIA, IIB, III, IV, and V, affecting different lipoprotein profiles.
    • Patients with homozygous familial hypercholesterolemia respond less well to the drugs.

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    Description

    This quiz covers the types and functions of antihyperlipidemic drugs, focusing on their role in managing cholesterol levels and reducing the risk of coronary heart disease (CHD). It includes specific classes of drugs such as statins and their impact on LDL and HDL cholesterol. Test your understanding of how lifestyle factors contribute to hyperlipidemia and the importance of drug therapy.

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