BSMCON Pathopharm I test 4 Questions And Answers With Verified Study Solutions

What are lipoproteins? - Answer--consist of various amounts of cholesterol, triglycerides, and phospholipids along with a protein carrier -classified according to their size, weight or density -not soluble in plasma, they must be specifically packaged for transport through the blood What is the main function of LDL? - Answer-transport cholesterol from liver to tissues What is the main function of HDL? - Answer-transport surplus cholesterol from tissues back to liver Where does cholesterol come from? - Answer---- What role does cholesterol play in the body? - Answer---- What are the goals for hyperlipidemia? - Answer---- Why is it so important to control cholesterol? - Answer---- Which cholesterol component is most closely related to heart disease? - Answer---- The purpose of testing cholesterol is to - Answer-identify patients at risk for atherosclerotic heart disease What are some drugs for hyperlipidemia? - Answer--HMG-CoA reductase inhibitors ("statins") -nicotinic acid -bile acid sequestrants/resins -ezetimibe -fibric acid derivativesSelection of drug and dose depends on: - Answer--patients allergies and medication tolerability -LDL and TG levels -co-morbid conditions What is the mechanism of action for "statins"? - Answer--inhibit HMG-CoA reductase -increases the LDL receptor sites on liver cells thus increasing the uptake of LDL from the blood -have been shown to slow the progression of CAD and to reduce mortality from cardiovascular disease -oral What are the prototypes for statin? - Answer--atorvastatin -lovastatin -simvastatin -pravastatin -fluvastatin -rosuvastatin draw slide 10 - AnswerWhat are some potential adverse effects of statins? - Answer--liver dysfunction -myopathy: muscle pain, tenderness, weakness-most common reason for discontinuation -rhabdomyolysis (breaks down overworked muscles) What are some clinical considerations for statins? - Answer--check LFTs prior to initiation and clinically thereafter if indicated -limit alcohol and acetaminophen use -take with evening meal (b/c it minimizes GI upset & cholesterol biosynthesis is greatest at night) -contraindicated in pregnancy -avoid grapefruit juice -careful with CYP 3A4 interactionsWhat is niacin (nicotinic acid) and the mechanism of action? - Answer--B complex vitamin -mechanism of action not fully understood; partial inhibition of fatty acid release from adipose tissue; increased lipoprotein lipase activity; reduces total cholesterol, TG,LDL & increases HDL -oral What are some adverse effects for niacin? - Answer--intense flushing of the face, head and neck= lobster! (can be reduced by taking aspirin 30 min or ibuprofen 60 min before each dose) -GI upset (nausea, bloating, diarrhea) (take with food) -hepatotoxic -hyperglycemia- not usually given for patients with diabetes What is bile acid sequestrants/resins and what is the mechanism of action? - Answer--synthesized from cholesterol; critical for breakdown of fats and fat-soluble vitamins; release into intestine in response to food -form a non-absorbable complex with bile acids in the intestine; inhibits reuptake of bile acids containing cholesterol and is excreted in the feces What are some examples of bile acid sequestrants/resins? - Answer--colesevelan -cholestyramine -colestipol What is the route and adverse effects for bile acid sequestrants/ resins? - Answer--oral, powdered and granular forms, tablets -constipation; bloating; nausea What are clinical considerations for bile acid sequestrants/resins? - Answer--take before meals -take other medications 2 hours before or 4 hours after taking bile sequestrants (will block absorption) -increase bulk and fluid in diet for constipation prevention -mix with 60 mL- 180 mL of water, juices, or pulpy fruits -drink IMMEDIATELY to avoid GI irritationWhat is the mechanism of action for ezetimibe? - Answer--inhibits cholesterol absorption in the small intestine -blocks absorption of both dietary (exogenous) and bile-secreted (endogenous) cholesterol, "food and family" -oral -often given with statins -slight increased risk of liver damage, myopathy with statins