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Rx Prep - Dyslipidemia
Terms in this set (50)
TC = what 4 components?
TG + VLDL + HDL + LDL
Non-HDL is calculated how?
TC - HDL
Plaques block _______ flow as well as has the potential to raise ________, break off and travel in the body, causing what?
blood, BP, stroke, MI
FH are _______ elevations in cholesterol. This is primary. What is secondary caused by?
severe, acquired is another name - 3 Ds - diet, diseases, drugs
Diets high in _______ fats can cause high cholesterol. Diseases such as obesity and _________ can cause this as well. What drugs increase cholesterol?
saturated, hypothyroidism, PIs, atypical antipsychotics, steroids, transplant drugs
What 3 drugs only increase LDL?
Fibric acids, SGLT2 inhibitors, TZDs
What 3 drugs/substances only increase TGs?
Propofol, IV lipid emulsions, alcohol
Non-HDL goal is?
What LDL is considered VERY high?
> or = 190
When can we not use the Friedewald equation for calculating LDL?
When TG >400 (someone didn't fast)
What is the Friedewald equation?
LDL = TC - HDL - (TG/5)
To lower TG, sometimes correcting __________ will lower this as well.
underlying diabetes, less sugar to be made into TGs
What 3 dietary additions can people make to lower cholesterol?
Plant sterols, stanols and fiber
We don't focus on goal lipid levels, but reduce the _______ risk of the patient.
Primary elevations of LDL > or = 190 gets a patient a _______ intensity statin.
High intensity will drop the LDL by what? Moderate and low?
50% or more, 30-50, <30
What are the 5 low intensity statins and doses?
SPPLF - simply pick perfect lipid foods, simvastatin 10mg, pravastatin 10-20, pitavastatin 1, lovastatin 20, fluvastatin 20-40
If LDL is elevated but on optimal statin dose, which do we add first, ezetimibe or PCSK9?
Zetia - cheaper
Statins lower TG by _______%
Statins lower _____ primarily, but also low _______ and raise ______
LDL, TG, HDL
Statins are pregnancy category _____ because the baby needs fat to develop, especially the organ of the ______
Are statins safe in breastfeeding?
What two drugs are CI with strong CYP3A4 inhibitors?
Simvastatin and Lovastatin
Myalgias and arthralgias describe the ________ from statins. What do they progress to potentially?
pain, myopathy and rhabdomyolysis
Pharmacists Rock At Saving Lives and Preventing Flu - Statin Equivalent doses
pitavastatin 2mg, rosuvastatin 5mg, atorvastatin 10, simvastatin 20, lovastatin 20, pravastatin 40, fluvastatin 80
Can statins cause glucose changes?
Yes, raise BG and A1C
Sam Loathes the Flu - what 3 statins should be taken in the evening? (which one with the evening meal?)
Simvastatin, Lovastatin IR - evening meal, Fluvastatin
What medication do you never want to combine with statins or it can result in myalgias and toxicity?
Gemfibrozil (lower TGs)
If a patient is having severe myalgias, we hold the statin for ___-___ weeks. Do we re-start or re-challenge?
2-4, yes, the same statin at a lower dose
Myopathy is muscle ______ with or without _____ elevations
How much does Zetia lower cholesterol?
The IMPROVE-IT study showed Zetia added to ______ intensity statin stable patients with recent _______ further lowered risk of CV events.
Is Zetia cleared through the liver?
Bile acids bind ______ in the intestines, form a complex and excrete it in the _______. How much do they lower LDL?
bile (which has cholesterol), 10-30%
Are bile acid sequestrants safe in pregnancy?
BAS - bile acid sequestrants can actually ______ TG, we don't use them if TG are >________.
What are the 3 main BAS?
Colesevelam, colestipol, cholestyramine
Cholestyramine is CI in complete ________ obstruction.
Colesevelam is CI in ______ obstruction. TG > _______, it is CI to use this agent.
colestipol and cholestyramine need to be separated from other drugs by ___-___ hours before or ___-___ hours after
Fibrates drop TG by ____-_____%. How much do they lower LDL?
Fibrates can ______ LDL when TG are high
Gemfibrozil should be taken ______ before breakfast and dinner
Fibrates are PPAR-gamma agonists, they decrease synthesis of what two molecules?
VLDL and TG, raise HDL
What are two most common fibrates?
Gemfibrozil and fenofibrate
Niacin lowers LDL by ____-____%. Lowers TG how much?
Niacin raises HDL by ____-____%, but is this truly helpful?
15-35, no - raising HDL through diet and exercise is more helpful
ER and SR niacin help control flushing, but are associated with more _____ toxicity. Is the flushing necessary to have TG lowering effect?
liver, yes - shows that it's working
Take niacin with ______, but avoid spicy things or _____ liquids
This set is often in folders with...
Rx Prep - Anticoagulation
Rx Prep - Renal Disease
Rx Prep - Hepatitis and Liver Disease
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