Term
|
Definition
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|
Term
| what qualifies as a CHD risk equivalent-5 |
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Definition
| diabetes, Framingham>20%, PAD (ATSC disease), AAA, symtpom of CHD-angina |
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Term
what are the risk factors that modify LDL goals: -5
what is a negative risk factor? |
|
Definition
HTN or on meds,
CHD history men<55, women<65
age>45 men, women>55
smoking
HDL<40;
HDL>60 |
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Term
| When do you do a Framingham risk score? |
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Definition
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Term
| if you have CHD or CHD risk equivalent- do you do a framingham? why? |
|
Definition
| NO! Bc already at very high risk! |
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Term
ATP III Low risk:
how mnay risk factors?
Famingham %?
LDL goal? when do you start TLC? when do you start meds? option range for drug? |
|
Definition
0-1 risks
no framingham
160
>160
>190
160-189 |
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|
Term
ATP III moderate risk:
how mnay risk factors?
Famingham %?
LDL goal? when do you start TLC? when do you start meds? optional range for drug? |
|
Definition
|
|
Term
ATP III moderately high risk:
how mnay risk factors?
Famingham %?
LDL goal? optional LDL goal?
when do you start TLC? when do you start meds? optional range for drug? |
|
Definition
2+
10-20%
<130
<100
>130
>130
100-129 |
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|
Term
ATP III high risk:
how mnay risk factors?
Famingham %?
LDL goal? optional LDL goal
when do you start TLC? when do you start meds? option range for drug? |
|
Definition
+2 risk, or CHd, CHD equivalent
>20%
<100; <70
>100
>100; <100 |
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|
Term
if person is high risk with:
LDL<100
HDL<30
TG>400
what do you prescribe? |
|
Definition
LDL lowering
AND fibric acid or niacin |
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|
Term
| what are reason to have LDL goal<70-4 |
|
Definition
multiple risk factros (diabetes!)
not controlled risk factors (still smoke)
metabolic syndrome
if have ACS |
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|
Term
TG has to be greater that what to do TG lwering as primary goal?
what can happen at TGs this high? |
|
Definition
|
|
Term
| when do you treat metabolic syndrome? |
|
Definition
| 3 mo. after intitaitng TLC |
|
|
Term
Metabolic syndrome needs _ creiteria
what are all 5? |
|
Definition
3
Abdominal obestiy- waist circ. >40 for men, >35 for woman
TG> 150 or on meds
HDL<40 for men, <50 for women or on meds
BP> 130/85 or on meds
Fasting GLucose>100 or on meds |
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|
Term
| what is the last step on the treatment planning: |
|
Definition
| if TG > 200 after meet LDL goal- set secondary goal for Non HDL Cholesterol |
|
|
Term
| what is the goal for Non-HDL cholesterol |
|
Definition
| 30 pts higher than LDL goal |
|
|
Term
| What are the options for lower non-HDL cholesterol-2 |
|
Definition
intensify LDL lowering drug
start TG (VLDL) lowering drug |
|
|
Term
| for TLC- how much cholesterol should you hvae per day |
|
Definition
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Term
| Which statins can be taken at any time during the day-3 |
|
Definition
atorvastatin
rosuvastatin
pitavastatin |
|
|
Term
| which statins are generic-3 |
|
Definition
simvastatin
lovastatin
pravastatin |
|
|
Term
| what is the statin that can be BID? why is this? |
|
Definition
fluvastatin
is one of the weakest statins |
|
|
Term
| what two things would you do a diagnostic for to monitor for statins and why |
|
Definition
LFTS-heptox
CK-myopathy/rhabdomylosis |
|
|
Term
| when do you check fro LFTS |
|
Definition
| baseline, 6-12 wks, ev yr |
|
|
Term
| is severe liver injury common or rare in statins |
|
Definition
|
|
Term
| how does rhabdomyolsis differ from myopathy |
|
Definition
| rhabdo- CK>10 xULN + elevtaed Sr Cr or IV therapy |
|
|
Term
greater risk for myotoxity with what statins- 2
with what med + statins? |
|
Definition
lovastatin, simvastatin
gemfibrozil |
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|
Term
|
Definition
|
|
Term
| what drug affects both 3A4 and 2C9 that statins go thru- |
|
Definition
|
|
Term
| grapefruit juice should be avoided in which statins- 3 |
|
Definition
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|
Term
Fibric acids are mostly used for-
why? |
|
Definition
|
|
Term
| whcih fribric acid derivative reduced both primary and seconadry events |
|
Definition
|
|
Term
| which fibrinic acid do you take 30 min before meals? |
|
Definition
|
|
Term
| which feneofibrate drug is approved for usewith statin |
|
Definition
|
|
Term
|
Definition
| GI, rash, heptox, myalgia |
|
|
Term
| which bile acid sequstrant has adhenernce issues? why is this? |
|
Definition
colestipol
bc have to titrate |
|
|
Term
which bile acdi sequestrant has is more tolerable and less drug interactons?
-what is the bad thinga bout it? |
|
Definition
|
|
Term
| which bile acid sequestrant is taken with meals? |
|
Definition
|
|
Term
| which class is CI in bowel obstruction |
|
Definition
|
|
Term
how is the monitoring for bile acid seuqestrants-
why? |
|
Definition
dont ahve to do alot
bc not absorbed |
|
|
Term
what 3 bile acid sequstrant shouldnt be used in PKU patients?
why? |
|
Definition
Prevalite, Questran, Cholestid
phenylalanine |
|
|
Term
| which drug class reccomends taking all other medicaitons at least 1 hr before or 4 hrs after?? |
|
Definition
|
|
Term
| why do bile acid sequstrants have a limited use? |
|
Definition
| tolerability of GI issues |
|
|
Term
| in patients that already have LDL<70 + low HDL, how does niacin affect? |
|
Definition
|
|
Term
niacin sustained rlease vs immediate release:
which has increased risk for haptox? so which i used more? |
|
Definition
sustained release
immediate release |
|
|
Term
|
Definition
|
|
Term
which niacain is preferrred overall?
why? |
|
Definition
Niaspan
decreased flushing |
|
|
Term
| why do 50% of ppl not tolerate niacin? |
|
Definition
|
|
Term
| how can you avoid flushing? |
|
Definition
| take aspirin 325 mg 30 min before first dose |
|
|
Term
| what 4 drugs do you monitor hepatox? |
|
Definition
statins
fibrinic acid
niacin
ezetimibe |
|
|
Term
| what drug class do you avoid in peptic ulcer diseasE? |
|
Definition
|
|
Term
want to avoid use of niacin with what bile acid sequestrant?
why? |
|
Definition
cholestryamine
decreases absorption |
|
|
Term
| which niacin has the most flushing? |
|
Definition
|
|
Term
| what is "no flush" niacin |
|
Definition
| not real niacin, dont take it! |
|
|
Term
Drug interactions of ezetimibe:
decreases-
increases- 2 things |
|
Definition
bile acid seq
warfarin, cyclosporin |
|
|
Term
do you monitor LFTs with ezetiimibe?
Does it have hepatatoxicity? |
|
Definition
|
|
Term
what are the Omega 3 Acids? -2
which is more ptoent? |
|
Definition
omega 3 esters
Icosapent ethyl;
omega 3 ester |
|
|
Term
| what is the drug class approved for severer TG (>500) |
|
Definition
|
|
Term
| what OTC can be ana lternative for Omega 3 acids- |
|
Definition
|
|
Term
| What is the dose for the omgea 3 acids |
|
Definition
|
|
Term
| what are 2 things that omega 3 acids lack that are beenficial- |
|
Definition
|
|
Term
| ezetimbe + statins are for- |
|
Definition
|
|
Term
| what is the most potent LDL agent |
|
Definition
| Vytorin (eztembie/simvastatin) |
|
|
Term
| in whihc dylipedmia can you not remove LDL? |
|
Definition
|
|
Term
| which omega 3 acid doesnt cause an increase in LDL (is a BENEFIT!) |
|
Definition
|
|
Term
| statin + fibrate used for |
|
Definition
|
|
Term
| statin + niacin used for- |
|
Definition
| better LDL, better TG, better HDL |
|
|
Term
what two statins are niacin combined with?
-what type of niacin is it? |
|
Definition
lovastatin
simvastatin
extedned release niacin |
|
|
Term
| niacin + bile acid seq used for- |
|
Definition
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