Podcast
Questions and Answers
What is a contraindication for bile acid binding resins?
What is a contraindication for bile acid binding resins?
- Digestive issues
- Hypercholesterolemia
- Hypersensitivity (correct)
- Pregnancy/Breastfeeding mother (correct)
What is the effect of bile acid binding resins on LDL receptors?
What is the effect of bile acid binding resins on LDL receptors?
- Increased (correct)
- Variable
- No effect
- Decreased
What is a side effect of bile acid binding resins?
What is a side effect of bile acid binding resins?
- Improved digestion
- Increased energy
- Weight gain
- GI discomfort (correct)
What is the mechanism of action of Cholestyramine?
What is the mechanism of action of Cholestyramine?
When should bile acid binding resins be administered in relation to other drugs?
When should bile acid binding resins be administered in relation to other drugs?
What is the effect of bile acid binding resins on absorption of vitamins and drugs?
What is the effect of bile acid binding resins on absorption of vitamins and drugs?
What type of patients may be prescribed Cholesterol absorption inhibitors as monotherapy?
What type of patients may be prescribed Cholesterol absorption inhibitors as monotherapy?
What is the effect of combining bile acid binding resins with statins?
What is the effect of combining bile acid binding resins with statins?
What is the primary mechanism of action of Ezetimibe?
What is the primary mechanism of action of Ezetimibe?
What is a potential side effect of Ezetimibe?
What is a potential side effect of Ezetimibe?
How do Bile acid binding resins affect Ezetimibe?
How do Bile acid binding resins affect Ezetimibe?
What is the mechanism of action of PCSK9 inhibitors?
What is the mechanism of action of PCSK9 inhibitors?
What population should avoid PCSK9 inhibitors?
What population should avoid PCSK9 inhibitors?
What effect do PCSK9 inhibitors have on LDL-c levels?
What effect do PCSK9 inhibitors have on LDL-c levels?
What is the mechanism of action of HMG CoA reductase inhibitors?
What is the mechanism of action of HMG CoA reductase inhibitors?
What is the effect of HMG CoA reductase inhibitors on LDL receptors?
What is the effect of HMG CoA reductase inhibitors on LDL receptors?
Which of the following is a side effect of HMG CoA reductase inhibitors?
Which of the following is a side effect of HMG CoA reductase inhibitors?
Which of the following HMG CoA reductase inhibitors is metabolized by CYP3A4?
Which of the following HMG CoA reductase inhibitors is metabolized by CYP3A4?
What is the clinical usage of HMG CoA reductase inhibitors?
What is the clinical usage of HMG CoA reductase inhibitors?
What is the effect of HMG CoA reductase inhibitors on atherosclerosis?
What is the effect of HMG CoA reductase inhibitors on atherosclerosis?
Which of the following medications may interact with HMG CoA reductase inhibitors?
Which of the following medications may interact with HMG CoA reductase inhibitors?
What is the alternative medication that may be considered in case of myopathy or rhabdomyolysis?
What is the alternative medication that may be considered in case of myopathy or rhabdomyolysis?
What is the purpose of using siRNA, including Inclisiran, in addition to statins?
What is the purpose of using siRNA, including Inclisiran, in addition to statins?
What is the main side effect of Gemfibrozil?
What is the main side effect of Gemfibrozil?
What percentage of fenofibrate is excreted in the urine?
What percentage of fenofibrate is excreted in the urine?
What is the main mechanism of action of fibric acid derivatives like fenofibrate?
What is the main mechanism of action of fibric acid derivatives like fenofibrate?
What is the indication for using fibric acid derivatives like Gemfibrozil?
What is the indication for using fibric acid derivatives like Gemfibrozil?
What is a potential complication of using fibric acid derivatives like fenofibrate?
What is a potential complication of using fibric acid derivatives like fenofibrate?
What is the effect of ω3-fatty acids on Liver TG?
What is the effect of ω3-fatty acids on Liver TG?
What is a potential side effect of Eicosapentaenoic acid (EPA)?
What is a potential side effect of Eicosapentaenoic acid (EPA)?
What is the relationship between ω3-fatty acids and PPARα activity?
What is the relationship between ω3-fatty acids and PPARα activity?
What is the effect of Decosahexaenoic acid (DHA) on triglycerides?
What is the effect of Decosahexaenoic acid (DHA) on triglycerides?
What is a potential interaction of ω3-fatty acids with other medications?
What is a potential interaction of ω3-fatty acids with other medications?
What is a potential benefit of ω3-fatty acids in liver disease?
What is a potential benefit of ω3-fatty acids in liver disease?
Study Notes
HMG CoA Reductase Inhibitors
- Also known as statins
- Inhibit HMG-CoA reductase, a rate-limiting enzyme
- Result: inhibition of de novo synthesis of cholesterol
- Clinical usage: hypercholesterolemia, CVD prevention, and restoration of vessel function
- Increase LDL receptors and HDL
- Examples: Atorvastatin, Lovastatin, Simvastatin
- Side effects: transaminase enzyme increase, myopathy, and rhabdomyolysis
- Contraindications: liver disease, pregnancy, breastfeeding, and hypersensitivity
Bile Acid Binding Resins
- Examples: Cholestyramine, Colestipol, Colesvelam
- Mechanism of action: inhibit enterohepatic circulation by binding to bile acid
- Clinical usage: hypercholesterolemia, especially when statins are contraindicated
- Generally safe, but may cause GI discomfort and decrease absorption of vitamins and drugs
Cholesterol Absorption Inhibitors
- Example: Ezetimibe
- Mechanism of action: inhibit intestinal absorption of cholesterol by blocking NPC1L1
- Clinical usage: hypercholesterolemia, especially in statin-intolerant patients
- Side effects: abdominal pain, diarrhea, and steatorrhea
- Bile acid binding resins inhibit absorption of ezetimibe
PCSK9 Inhibitors
- Examples: Alirocumab, Evolocumab, Inclisiran
- Mechanism of action: monoclonal antibody that binds to PCSK9, increasing LDL receptor recycling
- Clinical usage: severe hypercholesterolemia, especially in addition to statins
- Avoided in pregnancy and breastfeeding mothers
Fibric Acid Derivatives
- Examples: Gemfibrozil, Fenofibrate, Bezafibrate
- Mechanism of action: stimulate PPARα, increasing FA oxidation and decreasing VLDL and LDL
- Clinical usage: hypertriglyceridemia, chylomicronemia syndrome, and dysbetalipoproteinemia
- Side effects: myopathy, increased risk of gallstone formation, and liver hyperlipidemia
- Contraindications: liver disease, pregnancy, and gout
ω3-Fatty Acids
- Examples: Eicosapentaenoic acid (EPA), Decosahexaenoic acid (DHA)
- Mechanism of action: uncertain, may modulate PPARα activity
- Clinical usage: triglyceride reduction
- Side effects: prolonged bleeding time, interaction with antithrombotic drugs
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Description
Learn about statins, a type of medication that inhibits HMG-CoA reductase, a rate-limiting enzyme, and its effects on cholesterol synthesis, clinical usage, and side effects.
