Miscellaneous Quiz / Thera2-DyslipidemiaDrugs

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HintAnswer
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.
Brand Name Colesevelam
T or F: Ezetimibe should be used in caution in renal or hepatic impairment and are not recommended in moderate or severe hepatic impairment.
Fluvastatin 20mg lowers LDL by ___%
BAS are contraindicated in dysbeta-lipoproteinemia and TG > ____ mg/dL.
Verapamil, Cyclosporine, Protease Inhibitors, and Diltiazem'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.
Lowest dose of Simvastatin: ___mg
Omega-3 Fatty acid starting dose is: ___ g daily, which may then be increased to 4 grams daily with meals.
Lowest dose of Pravastatin: ___mg
T or F: CYP450 drug interactions are NOT a risk factor for myopathy because they result in increased statin concentration
T or F: XR Niacin has more hepatotoxicity and SR Niacin.
Which of the following statins is NOT metabolized by CYP3A4: (a) Simvastatin (b) Pravastatin (c) Lovastatin (d) Atorvastatin?
Fibric acid derivatives' MOA is increasing the functional activity of _______ ________.
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.
T or F: Bile Acid Sequestrant's mechanism of action with statins is intestinal drug binding resulting in INCREASED statin bioavailability.
T or F: Slo-Niacin is available as an OTC dietary supplement.
Term for 'muscle aches or weakness without CK (creatinine kinase) elevation.'
T or F: Statins are the most effective LDL lowering drugs and are therefore considered first line agents for LDL lowering.
T or F: Gemfibrozil has greater inhibition of glucuronidation than fenofibrate.
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
Niacin's mechanism of interaction with statins is: _______ effects
Which statin is most lipophilic and therefore most likely to cause myopathies?
Brand Name Pitavastatin
Brand Name Ezetimibe
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: 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
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
Which statin is the least potent in terms of % Reduction in LDL?
Fibric acid derivatives require ____ monitoring every 3 months for the first year, then periodically.
Brand Name Fenofibrate
Fibric acid derivatives may _______ ezetimibe's bioavailability.
Brand Name long-acting (sustained-release) Niacin
What statin is the most potent in terms of % reduction of LDL?
Statin monitoring: Muscle soreness, tenderness, or pain's follow-up schedule includes - baseline, __-12 weeks after initiation of therapy, and each follow-up visit.
Which drug class is pregnancy category X?
T or F: Other adverse effects of statins include: elevated hepatic transaminases, GI disturbance, headache, and rash.
The max dose per day of Slo-Niacin is: ___g/day.
Simvastatin 5mg lowers LDL by ___%
T or F: Gemfibrozil should be given 30 minutes prior to meals.
Rosuvastatin 5mg lowers LDL by ___%
Atorvastatin 10mg lowers LDL by ___%
T or F: Contraindications to statin use include active or chronic liver disease, concomitant use of interacting drugs, and pregnancy.
Patient education for statin's includes take at _______ and report any muscle pain/weakness, or brown urine.
HintAnswer
T or F: The combination of Fibric Acid derivatives and statins decreases the risk for myopathy.
An example of a cholesterol absorption inhibitor is: ________.
Brand Name for Omega-3 Fatty Acid
Pravastatin 10mg lowers LDL by ___%
Fibric acid derivates' place in therapy is first line for increased ____ and as additional therapy to statins.
Adverse effects of BAS include: GI distress, constipation, decreased absorption of other drugs and a 5-10% increase in _______.
Lowest dose of Rosuvastatin: ___mg
Brand Name Gemfibrozil
Slo-Niacin's dosing: Initiate ____-500mg/day, titrate slowly.
Fibric acid contraindications include: severe ______ or hepatic disease.
Gemfibrozil normal dosing is ____mg BID
Fenofibrate has shown reduced risk of ___ events in diabetic and nondiabetic populations.
Brand Name Immediate Release Niacin
T or F: Statin dosing can be determined using the '6% Rule.'
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
Brand Name Lovastatin
Brand Name Cholestyramine
The max dose per day of Niaspan is: ___g/day.
T or F: Regarding statins, the risk of myotoxicity is dose related.
T or F: Niacin SR is only available with a prescription.
Ezetimibes place in therapy is for additive ____ lowering in addition to statin.
Which statin undergoes glucuronidation/minimal CYP2C9?
Cyclosporine may _______ plasma concentrations of ezetimibe.
The starting doses for Fenofibrate are ___mg-145mg/day.
Brand Name Simvastatin
T or F: Regarding statin monitoring, CK's follow-up schedule includes - a baseline and as muscle symptoms develop.
T or F: Pharmacodynamic interactions with other myotoxic agents (i.e. fibrates or niacin) can result in additive effects.
T or F: It is advised when using niacin, to avoid switching formulations.
Niacor dosing: Initiate 50-___mg BID-TID; titrate slowly over 2-3 weeks to achieve goal dose.
Statin monitoring: ALT and AST follow-up includes - a baseline, __ weeks after initiation of therapy, then annually (more frequently if indicated).
T or F: Bile acid sequestrants do NOT interfere with ezetimibe's absorption.
Lowest dose of Lovastatin: ___mg
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.
Contraindications for Niacin therapy include: chronic liver disease, severe gout, PUD, and _______.
Niacin extended release has increased chance of the patient experiencing _______.
Term for 'muscle symptoms with increased creatinine kinase (CK) levels.'
Amiodarone's mechanism of interaction with statins is CYP2C9 and CYP____ inhibition.
Brand Name Pravastatin
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
Niacin immediate release has increased chance of the patient experiencing _______.
Brand Name Extended Release Niacin
Term for 'muscle symptoms with marked creatinine kinase elevation (> 10x ULN) and creatinine elevation (damage to kidneys).'
Atorvastatin Brand Name
T or F: Equivalent doses of one niacin product may be substituted for another.
HintAnswer
Ezetimibe dosing is ___mg PO daily - with or without food.
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
Brand Name Fluvastatin
BAS place in therapy is as an add-on therapy to statin (2nd or 3rd line agent) and ________.
Omega-3 Fatty acids should be used as an adjunct to diet in patients with a very high TG (> or = ______mg/dL)
Lowest dose of Pitavastatin: ___mg
Grapefruit Juice's mechanism of interaction with statins is CYP_____ inhibition
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.
Fibric Acid Derivative's mechanism of interaction with statins includes: additive effects and _________ inhibition (gemfibrozil).
T or F: An disadvantage of BAS is that they are systemically absorbed.
T or F: Statins decrease LDL receptor activity.
Niacin requires ___ monitoring.
The max dose of Fenofibrate is _____mg/day.
T or F: Bile Acid Sequestrants (BAS) MOA includes binding bile acid and preventing bile acid reabsorption.
Regarding 'statins' MOA, these drugs inhibit _____________, the enzyme that catalyzes the rate limiting step in cholesterol synthesis.
Niaspan dosing: Initiate ____mg HS x 1 month, then increase by _____mg/month until at desired dose
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).
T or F: Fenofibrate can be given without regard to meals
T or F: Statins increase clearance of LDL from blood.
Lovastatin 10mg lowers LDL by ___%
Which of the following are risk factors for myopathy? (a) female sex (b) older age (c) renal insufficiency (d) all of the above
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: Niacin's place in therapy is for combined hyperlipidemias and as either an additional therapy to statin or as alternative to statin.
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.
For BAS, it's wise to advise the patient to take other medications __ hour prior or 4 hours after administration.
T or F: Statin monitoring parameters include: muscle soreness, tenderness, or pain; CK; and ALT, AST.
Clarithromycin and Erythromycin's mechanism of interaction with statins is: CYP_____ inhibition.
Adverse effects for fibric acid derivatives include: _________, N/V, skin rash, gallstones, and myopathy.
Pitavastatin 1mg lowers LDL by ___%
Which of the following statins should the patient be instructed to take at bedtime: (a) atorvastatin (b) pravastatin (c) rosuvastatin (d) simvastatin (e) pitavastatin.
Lowest dose of Fluvastatin: ___mg
Omega-3 Fatty Acids' place in therapy is for: ____________.
Brand Name Colestipol
Which of the following is NOT an adverse effect of ezetimibe: (a) nausea (b) diarrhea (c) flatulence (d) myalgia
T or F: Niacor's required multiple daily dosing may worsen compliance.
Brand Name Rosuvastatin
Niacor's usual dose is 1.5g - ___g/day.
An important point of patient education for Niacin is to instruct the patient to take it with _______.
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.'
Lowest dose of Atorvastatin: __mg
Ezetimibe may ________ the anticoagulant effect of warfarin.
Azole Antifungal's mechanism of interaction with statins is CYP3A4 inhibition, P-glycoprotein inhibition, and CYP____ (fluconazole).
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