Lipids therapeutics

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ba
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266065
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Lipids therapeutics
Updated:
2014-03-11 23:12:44
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Lipids therapeutics
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Lipids therapeutics
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  1. what's the difference between hyperlipidemia and dyslipidemia?
    • hyper = elevated cholesterol
    • dys = messed up cholesterol (not normal)
  2. what are secondary causes of dyslipidemia and how do they affect TC, TG, LDL, HDL?
    • DM; inc TC, TG, LDL and dec HDL
    • alcoholism inc TG and HDL
    • Obstructive Liver Dz; inc TC, abnormal LDL
    • Sedentary Lifestyle; dec HDL
    • obesity; inc TG, dec HDL
    • hypothyroidism; inc LDL, possibly inc TG
  3. What are the dgs that induce hyperlipidemia?
    • diuretics (thiazides, loops)
    • beta-blockers
    • alpha agonists and antagonists
    • OCs
    • glucocorticoids
    • ethanol
    • isotretinoin
  4. what was the paradigm shift in new treatment guidelines for dyslipidemia?
    • tx to reduce atherosclerotic cv dz
    • statin benefit groups
    • out with the old (tx to goal = tx to target, lower is best, tx level of risk, tx lifetime risk)
  5. what is ASCVD?
    • MI
    • Stable and unstable
    • PAD/revascularization
    • TIA/Stroke
    • cornoary revascularization
  6. What are lifestyle modifications?
    • inc intake of fruits, veggies and whole grains
    • reduce calories from sat fat
    • reduce percent of calories from trans fat
    • engage in aerobic activity (40 mins, 3 times/wk)
  7. What are the 4 benefit groups?
    • 1. cholesterol >190, 
    • 2. secondary prevention (ascvd)
    • 3. diabetes with cholesterol 70 - 189 and 40-75 yo
    • 4. 10 yr risk >7.5%, no diabetes
  8. what is the tx for group 1?
    • </= 75 = high intensity
    • >75 = mod
  9. what is the tx for group 2?
    • >75 = mod
    • </=75 = high
  10. What is the tx for group 3?
    • ASCVD risk <7.5% = mod
    • ASCVD risk >/= = high
  11. what is the tx for group 4?
    mod-high for >/= 7.5%
  12. what are the two exceptions to guideline tx recommendations?
    • CHF
    • hemodialysis (kid dz)
  13. what are the high intensity statins?
    • atorvastatin 40 - 80mg
    • rosuvastatin 20mg
  14. what are the absolute CI to statins?
    • active or chronic liver dz
    • pregnancy
    • lactation

    (relative = concomitant use of certain drugs)
  15. What are the drug interactions with HMG-CoA RI?
    • 3A4 - atorvastatin, flu, lov, sim
    • 2C9 - flu, ros
    • glucoronidation - pravastatin
  16. What is the cholesterol absorption inhibitor and its side effect??
    • zetia
    • well tolerated
    • sever diarrhea, myalgias, rhabdo, hepatitis - more likely with combo therapy
  17. CI to Zetia?
    mod - severe hepatic insufficiency
  18. What are the fibric acid derivatives?
    • lopid (gemfibrozil)
    • tricor/trilipix (fenofibrate)
  19. what are the CIs to fibric acid?
    • hepatic or sever renal dysfxn
    • primary biliary cirrhosis
    • gallbladder dz
  20. what are the side effects of fibric acid?
    • rash
    • diarrhea, nausea, ab pain - inc risk of gallstones
    • dec hgb/hct
    • myopathy
    • elevated lfts
    • DO NOT GIVE GEMFIBROZIL AND STATINS TOGETHER
  21. What are the CIs to niacin?
    • absolute - hepatic dysfxn
    • relative - DM, peptic ulcer, gout
  22. what are the CIs to bile acid sequestrants?
    • absolute - TG > 400, complete biliary obstruction
    • relative - TG > 200
  23. what are the bile acid sequestrants?
    • colestid (colestipol)
    • questran (cholestyramine)
    • welchol (colesevelam)
  24. what are the education points of bile acid sequestrants?
    take before meals

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