Pharm (5b) Chol
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16 terms
Terms | Definitions |
|---|---|
 ***ATORVASTATIN: | • Class- o HMG CoA reductase inhibitor (statins) o GOLD STANDARD THERAPY FOR LIPIDS • Action- o CARDIOPROTECTIVE o By blocking cholesterol synthesis, statins reduce LDL by increasing LDL receptor synthesis thus removing LDL from the blood o Lowers secretion of VLDL o Reduce triglycerides • Indication- o High cholesterol o THE BEST • Side-effect- o ***HEPATOTOXICITY: (blood test needed and is supposed to be stable) o ***MYOPATHY: (DOSE DEPENDENT. HIGHER OR MORE POWERFUL THE MORE LIKELY) o IF MYOPATHY (MUSCLE WEAKNESS/CREATINE KINASE 10XS NORMAL) HAPPENS, STOP DRUG IMMEDIATELY • Contra- o PREGNANCY CATEGORY X o ABSOLUTE CONTRAINDICATION ACTIVE LIVER DISEASE • Pharm- o Orally active, extensive first pass effect • Misc- o BLOOD TESTING NEEDED |
| ***SIMVASTATIN: | • Class- o HMG CoA reductase inhibitor (statins) o GOLD STANDARD THERAPY FOR LIPIDS • Action- o CARDIOPROTECTIVE o By blocking cholesterol synthesis, statins reduce LDL by increasing LDL receptor synthesis thus removing LDL from the blood o Lowers secretion of VLDL o Reduce triglycerides • Indication- o High cholesterol • Side-effect- o ***HEPATOTOXICITY: (blood test needed and is supposed to be stable) o ***MYOPATHY: (DOSE DEPENDENT. HIGHER OR MORE POWERFUL THE MORE LIKELY) o IF MYOPATHY (MUSCLE WEAKNESS/CREATINE KINASE 10XS NORMAL) HAPPENS, STOP DRUG IMMEDIATELY • Contra- o PREGNANCY CATEGORY X o ABSOLUTE CONTRAINDICATION ACTIVE LIVER DISEASE o GRAPEFRUIT JUICE • Pharm- o Orally active, extensive first pass effect • Misc- o Prodrug o BLOOD TESTING NEEDED |
| ***Rosuvastatin: | • Class- o HMG CoA reductase inhibitor (statins) o GOLD STANDARD THERAPY FOR LIPIDS • Action- o CARDIOPROTECTIVE o By blocking cholesterol synthesis, statins reduce LDL by increasing LDL receptor synthesis thus removing LDL from the blood o Lowers secretion of VLDL o Reduce triglycerides • Indication- o High cholesterol • Side-effect- o ***HEPATOTOXICITY: (blood test needed and is supposed to be stable) o ***MYOPATHY: (DOSE DEPENDENT. HIGHER OR MORE POWERFUL THE MORE LIKELY) o IF MYOPATHY (MUSCLE WEAKNESS/CREATINE KINASE 10XS NORMAL) HAPPENS, STOP DRUG IMMEDIATELY • Contra- o PREGNANCY CATEGORY X o ABSOLUTE CONTRAINDICATION ACTIVE LIVER DISEASE • Pharm- o Orally active, extensive first pass effect • Misc- o BLOOD TESTING NEEDED |
| ***Pitavastatin: | • Class- o HMG CoA reductase inhibitor (statins) o GOLD STANDARD THERAPY FOR LIPIDS • Action- o CARDIOPROTECTIVE o By blocking cholesterol synthesis, statins reduce LDL by increasing LDL receptor synthesis thus removing LDL from the blood o Lowers secretion of VLDL o Reduce triglycerides • Indication- o High cholesterol • Side-effect- o ***HEPATOTOXICITY: (blood test needed and is supposed to be stable) o ***MYOPATHY: (DOSE DEPENDENT. HIGHER OR MORE POWERFUL THE MORE LIKELY) o IF MYOPATHY (MUSCLE WEAKNESS/CREATINE KINASE 10XS NORMAL) HAPPENS, STOP DRUG IMMEDIATELY • Contra- o PREGNANCY CATEGORY X o ABSOLUTE CONTRAINDICATION ACTIVE LIVER DISEASE • Pharm- o Orally active, extensive first pass effect • Misc- o BLOOD TESTING NEEDED |
| Fluvastatin: | • Class- o HMG CoA reductase inhibitor (statins) o GOLD STANDARD THERAPY FOR LIPIDS • Action- o By blocking cholesterol synthesis, statins reduce LDL by increasing LDL receptor synthesis thus removing LDL from the blood o Lowers secretion of VLDL o Reduce triglycerides • Indication- o High cholesterol • Side-effect- o ***HEPATOTOXICITY: (blood test needed and is supposed to be stable) o ***MYOPATHY: (DOSE DEPENDENT. HIGHER OR MORE POWERFUL THE MORE LIKELY) o IF MYOPATHY (MUSCLE WEAKNESS/CREATINE KINASE 10XS NORMAL) HAPPENS, STOP DRUG IMMEDIATELY • Contra- o PREGNANCY CATEGORY X o ABSOLUTE CONTRAINDICATION ACTIVE LIVER DISEASE • Pharm- o Orally active, extensive first pass effect • Misc- o BLOOD TESTING NEEDED |
| Lovastatin: | • Class- o HMG CoA reductase inhibitor (statins) o GOLD STANDARD THERAPY FOR LIPIDS • Action- o By blocking cholesterol synthesis, statins reduce LDL by increasing LDL receptor synthesis thus removing LDL from the blood o Lowers secretion of VLDL o Reduce triglycerides • Indication- o High cholesterol • Side-effect- o ***HEPATOTOXICITY: (blood test needed and is supposed to be stable) o ***MYOPATHY: (DOSE DEPENDENT. HIGHER OR MORE POWERFUL THE MORE LIKELY) o IF MYOPATHY (MUSCLE WEAKNESS/CREATINE KINASE 10XS NORMAL) HAPPENS, STOP DRUG IMMEDIATELY • Contra- o PREGNANCY CATEGORY X o ABSOLUTE CONTRAINDICATION ACTIVE LIVER DISEASE o GRAPEFRUIT JUICE • Pharm- o Orally active, extensive first pass effect • Misc- o Prodrug o BLOOD TESTING NEEDED |
| Pravastatin: | • Class- o HMG CoA reductase inhibitor (statins) o GOLD STANDARD THERAPY FOR LIPIDS • Action- o By blocking cholesterol synthesis, statins reduce LDL by increasing LDL receptor synthesis thus removing LDL from the blood o Lowers secretion of VLDL o Reduce triglycerides • Indication- o High cholesterol • Side-effect- o ***HEPATOTOXICITY: (blood test needed and is supposed to be stable) o ***MYOPATHY: (DOSE DEPENDENT. HIGHER OR MORE POWERFUL THE MORE LIKELY) o IF MYOPATHY (MUSCLE WEAKNESS/CREATINE KINASE 10XS NORMAL) HAPPENS, STOP DRUG IMMEDIATELY • Contra- o PREGNANCY CATEGORY X o ABSOLUTE CONTRAINDICATION ACTIVE LIVER DISEASE • Pharm- o Orally active, extensive first pass effect • Misc- o BLOOD TESTING NEEDED |
| Cholestyramine: | • Class- o Bile acid sequesterant • Action- o Positively charged resins that bind negatively charged bile acids thus decreasing hepatic cholesterol content and increasing LDL clearance from blood • Indication: o High cholesterol o Preferred agent • Side-effect- o HYPERTRIGLYCERIDEMIA (triglyceride synthesis is stimulated) o Bloating, dyspepsia, constipation & flatulence o May interfere with fat soluble vitamin absorption (use vitamin supplement) • Contra- O DO NOT USE IN PTS WITH ELEVATED TRIGLYCERIDES o Binding drugs (administer 1 hr before or 2-2 hrs after using sequesterants) • Misc- o NOT FOR USE IF TRYGLYCERIDES >400 |
| Colestipol: | • Class- o Bile acid sequesterant • Action- o Positively charged resins that bind negatively charged bile acids thus decreasing hepatic cholesterol content and increasing LDL clearance from blood • Indication: o High cholesterol o Preferred agent • Side-effect- o HYPERTRIGLYCERIDEMIA (triglyceride synthesis is stimulated) o Bloating, dyspepsia, constipation & flatulence o May interfere with fat soluble vitamin absorption (use vitamin supplement) • Contra- O DO NOT USE IN PTS WITH ELEVATED TRIGLYCERIDES o Binding drugs (administer 1 hr before or 2-2 hrs after using sequesterants) • Misc- o NOT FOR USE IF TRYGLYCERIDES >400 |
| Colesevelam: | • Class- o Bile acid sequesterant • Action- o Positively charged resins that bind negatively charged bile acids thus decreasing hepatic cholesterol content and increasing LDL clearance from blood • Indication: o High cholesterol o Preferred agent • Side-effect- o HYPERTRIGLYCERIDEMIA (triglyceride synthesis is stimulated) o Bloating, dyspepsia, constipation & flatulence o May interfere with fat soluble vitamin absorption (use vitamin supplement) • Contra- O DO NOT USE IN PTS WITH ELEVATED TRIGLYCERIDES o Binding drugs (administer 1 hr before or 2-2 hrs after using sequesterants) • Misc- o NOT FOR USE IF TRYGLYCERIDES >400 |
| Ezetimibe: | • Class- o Cholesterol absorption inhibitors • Action- o Inhibits intestinal absorption of cholesterol and related phytosterols blocking intestinal transporters o Not very effective o Not cardioprotective • Indication- o High cholesterol • Contra- o Interacts with HMG CoA Reductase inhibitors o Do not use in Pts with active liver disease or elevated serum transaminases • Pharm- o Does not affect fat soluble vitamin absorption o May split pill to save $$$ |
| Ezetimibe + Simvastatin: | • Class- o Cholesterol absorption inhibitors • Action- o Inhibits intestinal absorption of cholesterol and related phytosterols blocking intestinal transporters o Super additive in lowering cholesterol but does not reduce morbidity or mortality • Side-effect- o Risk of myopathy may be elevated • Indication- o High cholesterol • Pharm- o Ezetimibe at fixed dose so tablets may NOT be split o Ezetimibe has the mech, but simvastatin makes it work well |
| Vitamin B3, Niacin, Niaspan: | • Action- o INHIBITS TRIGLYCERIDE SYNTHESIS o Reduces VLDL synthesis o Reduces LDL levels o Reduces HDL clearance • Side-effect- o FLUSHING AND PRURITUS (reduced by aspirin and may be more frequent when not compliant) o Dyspepsia o Hepatotoxicity o Hyperglycemia in diabetics o Hyperuricemia • Contra- o ***ABSOLUTE CONTRAINDICATION: LIVER DISEASE & GOUT o Relative contraindication: diabetes, hyperuricemia, PUD |
| Gemfibrozil: | • Class- o Fibric acid • Action- o Unclear mechanism (activates PPAR-alpha to suppress genes associated with lipid metabolism) o Reduces triglyceride-rich lipoproteins o Increases HDLs • Indication: o Use in combo with statins to improve outcome • Side-effect- o Bone marrow suppression o Myositis flu-like syndrome (myopathy) • Contra- o Severe renal disease o Severe hepatic disease • Misc- o Does not improve outcome in diabetes |
| Fish oils: | • Class- o CAM • Action- o Omega-3 fatty acids lower triglycerides (MOA similar to fibrates) • Side-effect- o Excess bleeding |
| Red yeast rice: | • Class- o CAM • Action- o Contains monacolin K, which inhibits HMG-CoA reductase • Indication- o May be a supplement for Pts who can't take statins • Side-effect- o Adverse effects similar to statins • Misc- o No blood checks needed like statins O PREGNANCY ISSUE |
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