Miscellaneous Quiz / Thera2-DyslipidemiaDrugs

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QUIZ: Can you name the Thera2-DyslipidemiaDrugs?

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Fibric acid derivates' place in therapy is first line for increased ____ and as additional therapy to statins.
BAS place in therapy is as an add-on therapy to statin (2nd or 3rd line agent) and ________.
Brand Name Pitavastatin
T or F: Patient education for BAS includes: mixing powders with water, juice, or noncarbonated beverages; take with meals; do not hold in mouth or sip for prolonged periods; refrig
Brand Name Gemfibrozil
T or F: It is advised when using niacin, to avoid switching formulations.
Which of the following are risk factors for myopathy? (a) female sex (b) older age (c) renal insufficiency (d) all of the above
T or F: When on statin therapy, the appropriate action to take if there are muscle Sxs + CK elevation > 10x ULN is to: D/C statin - follow CK weekly.
Lowest dose of Fluvastatin: ___mg
Statin monitoring: Muscle soreness, tenderness, or pain's follow-up schedule includes - baseline, __-12 weeks after initiation of therapy, and each follow-up visit.
T or F: Statins are the most effective LDL lowering drugs and are therefore considered first line agents for LDL lowering.
Azole Antifungal's mechanism of interaction with statins is CYP3A4 inhibition, P-glycoprotein inhibition, and CYP____ (fluconazole).
T or F: CYP450 drug interactions are NOT a risk factor for myopathy because they result in increased statin concentration
T or F: Gemfibrozil should be given 30 minutes prior to meals.
T or F: Slo-Niacin is available as an OTC dietary supplement.
Fenofibrate has shown reduced risk of ___ events in diabetic and nondiabetic populations.
Statin monitoring: ALT and AST follow-up includes - a baseline, __ weeks after initiation of therapy, then annually (more frequently if indicated).
T or F: Other adverse effects of statins include: elevated hepatic transaminases, GI disturbance, headache, and rash.
Regarding 'statins' MOA, these drugs inhibit _____________, the enzyme that catalyzes the rate limiting step in cholesterol synthesis.
Niacin requires ___ monitoring.
Fibric acid derivatives require ____ monitoring every 3 months for the first year, then periodically.
T or F: An disadvantage of BAS is that they are systemically absorbed.
T or F: the MOA of ezetimibe inhibits absorption of dietary and biliary cholesterol by blocking transport at the brush boarder of the small intestine.
Fibric acid derivatives' MOA is increasing the functional activity of _______ ________.
The max dose of Fenofibrate is _____mg/day.
Rosuvastatin 5mg lowers LDL by ___%
Tips to reduce flushing caused by niacin include: take with meal, take ____ 30 minutes prior to use, and avoid hot drinks, alcohol, or hot showers near dose.
Fibric acid derivatives may _______ ezetimibe's bioavailability.
T or F: Equivalent doses of one niacin product may be substituted for another.
Clarithromycin and Erythromycin's mechanism of interaction with statins is: CYP_____ inhibition.
T or F: Patient education for Omega-3 fatty acids includes taking it immediately prior to meals to decrease fishy taste.
Which statin undergoes glucuronidation/minimal CYP2C9?
Lowest dose of Pitavastatin: ___mg
Term for 'muscle symptoms with increased creatinine kinase (CK) levels.'
Atorvastatin 10mg lowers LDL by ___%
Fibric acid contraindications include: severe ______ or hepatic disease.
T or F: Statins increase clearance of LDL from blood.
LFT monitoring for niacin therapy should be done: at initiation of therapy, every __-12 weeks for the 1st year, then periodically (1-2x per year).
Brand Name Colestipol
Niaspan dosing: Initiate ____mg HS x 1 month, then increase by _____mg/month until at desired dose
Contraindications for Niacin therapy include: chronic liver disease, severe gout, PUD, and _______.
Niacin extended release has increased chance of the patient experiencing _______.
T or F: When on statin therapy, the appropriate action if there's myopathy Sxs with no CK elevation is to: rule out other causes and monitor, may continue statin.
Lowest dose of Atorvastatin: __mg
HintAnswer
Lowest dose of Lovastatin: ___mg
T or F: When on statin therapy, the appropriate action to take if there's muscle Sxs + moderate CK elevation (3-10 x ULN) is to: continue statin - follow CK weekly until Sxs resolv
The max dose per day of Niaspan is: ___g/day.
An important point of patient education for Niacin is to instruct the patient to take it with _______.
Omega-3 Fatty acids should be used as an adjunct to diet in patients with a very high TG (> or = ______mg/dL)
T or F: Niacin's place in therapy is for combined hyperlipidemias and as either an additional therapy to statin or as alternative to statin.
BAS are contraindicated in dysbeta-lipoproteinemia and TG > ____ mg/dL.
Brand Name Simvastatin
The starting doses for Fenofibrate are ___mg-145mg/day.
Lovastatin 10mg lowers LDL by ___%
Which of the following statins is NOT metabolized by CYP3A4: (a) Simvastatin (b) Pravastatin (c) Lovastatin (d) Atorvastatin?
Omega-3 Fatty acid starting dose is: ___ g daily, which may then be increased to 4 grams daily with meals.
Brand Name Cholestyramine
Which statin is most lipophilic and therefore most likely to cause myopathies?
An example of a cholesterol absorption inhibitor is: ________.
T or F: Statin monitoring parameters include: muscle soreness, tenderness, or pain; CK; and ALT, AST.
T or F: When on statin therapy, the appropriate action to take if LFT elevates > 3x ULN is to: retest (could be random), if persists, decrease statin dose and monitor (may continue
T or F: Pharmacodynamic interactions with other myotoxic agents (i.e. fibrates or niacin) can result in additive effects.
Verapamil, Cyclosporine, Protease Inhibitors, and Diltiazem's mechanism of interaction with statins is CYP____ inhibition.
Brand Name long-acting (sustained-release) Niacin
Brand Name for Omega-3 Fatty Acid
Niacin's mechanism of interaction with statins is: _______ effects
Term for 'muscle symptoms with marked creatinine kinase elevation (> 10x ULN) and creatinine elevation (damage to kidneys).'
Ezetimibes place in therapy is for additive ____ lowering in addition to statin.
Niacin immediate release has increased chance of the patient experiencing _______.
Term for 'muscle aches or weakness without CK (creatinine kinase) elevation.'
Atorvastatin Brand Name
Patient education for statin's includes take at _______ and report any muscle pain/weakness, or brown urine.
Cyclosporine may _______ plasma concentrations of ezetimibe.
T or F: Statins decrease LDL receptor activity.
Brand Name Lovastatin
Which of the following is not an adverse effect of Niacin: (a) flushing (b) myopathies (c) hyperglycemia (d) hyperuricemia (e) hepatotoxicity (f) GI upset (g) PUD
Lowest dose of Rosuvastatin: ___mg
For BAS, it's wise to advise the patient to take other medications __ hour prior or 4 hours after administration.
T or F: Statin dosing can be determined using the '6% Rule.'
Brand Name Colesevelam
Pitavastatin 1mg lowers LDL by ___%
T or F: Bile acid sequestrants do NOT interfere with ezetimibe's absorption.
Which of the following is NOT an adverse effect of ezetimibe: (a) nausea (b) diarrhea (c) flatulence (d) myalgia
Brand Name Rosuvastatin
T or F: The combination of Fibric Acid derivatives and statins decreases the risk for myopathy.
Niacor dosing: Initiate 50-___mg BID-TID; titrate slowly over 2-3 weeks to achieve goal dose.
What statin is the most potent in terms of % reduction of LDL?
T or F: Ezetimibe should be used in caution in renal or hepatic impairment and are not recommended in moderate or severe hepatic impairment.
HintAnswer
T or F: XR Niacin has more hepatotoxicity and SR Niacin.
Fluvastatin 20mg lowers LDL by ___%
Simvastatin 5mg lowers LDL by ___%
Which drug class is pregnancy category X?
Brand Name Fenofibrate
Gemfibrozil normal dosing is ____mg BID
Niacor's usual dose is 1.5g - ___g/day.
Brand Name Pravastatin
Brand Name Extended Release Niacin
Which of the following is NOT considered a 'pleiotropic effect' of statins: (a) improve endothelial functions, (b) plaque stabilization, (c) increase synthesis of HDL, or (d) decre
T or F: Omega-3 fatty acids work because they are alternative substrates for TG synthesis and inhibit esterification of TG and other fatty acids.
T or F: When on statin therapy, the appropriate action to take if there's a modest baseline elevation (< 3x ULN) of LFTs is: perform close follow-ups, but note there is no contrain
Which of the following statins should the patient be instructed to take at bedtime: (a) atorvastatin (b) pravastatin (c) rosuvastatin (d) simvastatin (e) pitavastatin.
Omega-3 Fatty Acids' place in therapy is for: ____________.
Lowest dose of Simvastatin: ___mg
Adverse effects of Omega-3 Fatty acids include: dyspepsia, nausea, fishy taste or 'fishy burp', ____ in INR in patients on warfarin with high doses (4g)
T or F: Regarding statin monitoring, CK's follow-up schedule includes - a baseline and as muscle symptoms develop.
T or F: Bile Acid Sequestrants (BAS) MOA includes binding bile acid and preventing bile acid reabsorption.
Ezetimibe dosing is ___mg PO daily - with or without food.
Which statin is the least potent in terms of % Reduction in LDL?
T or F: Regarding statins, the risk of myotoxicity is dose related.
T or F: Niacor's required multiple daily dosing may worsen compliance.
T or F: Niacin's MOA is not completely understood, but it could be used as a primary agent since it does everything 'really well.'
Fibric Acid Derivative's mechanism of interaction with statins includes: additive effects and _________ inhibition (gemfibrozil).
Brand Name Immediate Release Niacin
Grapefruit Juice's mechanism of interaction with statins is CYP_____ inhibition
Brand Name Fluvastatin
Lowest dose of Pravastatin: ___mg
Ezetimibe may ________ the anticoagulant effect of warfarin.
The max dose per day of Slo-Niacin is: ___g/day.
Slo-Niacin's dosing: Initiate ____-500mg/day, titrate slowly.
T or F: Contraindications to statin use include active or chronic liver disease, concomitant use of interacting drugs, and pregnancy.
Niacin accomplishes which of the following: (a) reduces hepatic synthesis of TG and secretion or VLDL (b) inhibits the conversion of VLDL into LDL - increased HDL (c) inhibit mobil
Pravastatin 10mg lowers LDL by ___%
Adverse effects for fibric acid derivatives include: _________, N/V, skin rash, gallstones, and myopathy.
T or F: Fenofibrate can be given without regard to meals
Amiodarone's mechanism of interaction with statins is CYP2C9 and CYP____ inhibition.
T or F: Gemfibrozil has greater inhibition of glucuronidation than fenofibrate.
Brand Name Ezetimibe
Adverse effects of BAS include: GI distress, constipation, decreased absorption of other drugs and a 5-10% increase in _______.
T or F: Niacin SR is only available with a prescription.
T or F: Bile Acid Sequestrant's mechanism of action with statins is intestinal drug binding resulting in INCREASED statin bioavailability.

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