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52 Cards in this Set
- Front
- Back
strong 3A4 inhibitors? |
- itraconazole, ketoconazole, posaconazole, voriconazole - erythromycin, clarithromycin, telithromycin - HIV protease inhibitors - cobicistat containing - nefazodone, cyclosporine - gemfibrozil, Danazol, Grapefruit juice |
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what drugs given by SC? |
- alirocumab (Praluent) - evolocumab (Repatha) -mipomersen (Kynamro) |
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how to take Niaspan? |
- Niaspan is taken at HS after a low-fat snack |
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what are parameters use to assess on the Global Risk Assessment tool? |
- gender, age, race - TC, HDL, BP - antihypertensive drug is used? - DM - smoking status |
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what is the max dose for lovastatin while patient takes verapamil? |
max dose of lovastatin is 20 mg QD |
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when do you use primary prevention for high intensity of statin? |
- LDL >= 190 - DM, 40-75yo, LDL (70-189), ASCVD >=7.5% - 40-75yo has MI |
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when do you use secondary prevention for high intensity of statin? |
clinical ASCVD <= 75 years |
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when do you use secondary prevention for moderate-intensity of statin? |
clinical ASCVD > 75 years |
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Statin treatment for high intensity that will decrease LDL >= 50% ??? |
- Atorvastatin 40-80 mg QD - Rosuvastatin 20-40 mg QD |
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what concerns for bile acid sequestrants? |
- The agents in this class can cause constipation and adequate fluid and fiber intake is required; a laxative may be needed. - Instruct the patient to maintain adequate fluid intake and to take a multivitamin at another time of day. |
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generic for Vascepa? |
icosapent ethyl (will lower Trigs) |
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WelChol can lower or raise TG? |
WelChol will raise TG ~5% |
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What WelChol can do for the blood glucose?
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Welchol can lower hemoglobin A1C ~0.5% by decreasing postprandial blood glucose. |
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what caution about Epanova? |
Epanova can increase bleeding risk |
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what is Epanova? |
omega-3 carboxylic acid |
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Niacin and gout? |
Niacin can raise uric acid levels and should be used with caution in patients with gout. |
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what medications should be avoided with Simvastatin? |
- Lopid - VFEND - Biaxin |
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what is the MOA of Statins? |
The statins block cholesterol synthesis by inhibiting the enzyme HMG-CoA reductase, which catalyzes the rate-limiting step in cholesterol synthesis. |
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What need to be counseled on Advicor? |
Advicor contains a statin (lovastatin) and niacin extended-release. There is a heightened risk of muscle toxicity. Instruct patients to report at once any unexplained muscle pain, tenderness, or weakness. |
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Statin should be stop when? |
Statins should be stopped once the LFTs are 3 times above the upper limit of normal (ULN). |
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in what conditions are the fenofibrate agents contraindicated? |
- Gallbladder disease - Severe liver disease - can NOT be used in nursing mother |
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Counseling for Lovaza? |
- The usual dose of Lovaza is 4 capsules daily, which can be divided BID. - Lovaza can be tried as an alternative to fenofibrates for lowering TGs. - Lovaza should be used in addition to a low-fat diet. - If the patient uses OTC fish oils, he/she may need to double the amount of capsules to get similar TG lowering. |
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If a patient suffer from red, itchy skin from taking Niaspan, what is the counseling? |
- may take 325mg ASA 30mins before Niaspan to reduce the symptoms - Avoid alcohol, spicy food - symptoms should lessen over time - take Niaspan at bed time |
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when should the Simvastatin should be taken? |
Simvastatin is taken at bedtime, with or without food. Simvastatin has a short half life and must be in the body during sleep when most cholesterol synthesis occurs. The max dose for new starts is 40 mg/day. |
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How often should the Global Risk Assessment tool be done if a patient is classified as low risk? |
every 4-6 years |
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generic for Crestor? |
rosuvastatin |
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what are the SE of taking statin? |
- risk of DM - memory loss - myopathy |
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What fibrate must be taken 30 mins before breakfast and dinner? (Lopid, Tricor, Lofibra, Trilipix, Fibricor) |
Lopid |
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generic name for Livalo? |
pitavastatin |
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what statin should be taken with the evening meal? |
Lovastatin immediate-release (Mevacor) |
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SE of Lovaza? |
- burping - dyspepsia - taste perversions |
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generic for Mevacor? |
lovastatin |
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generic for Advicor? |
Lovastatin/Niacin |
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generic for Simcor? |
Simvastatin/Niacin |
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what drugs could adversely affect the lipid profile? |
- cyclosporine - amiodarone - prednisone - beta blocker |
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what is dose for Simvastatin when pt takes 20mg ditiazem and ranolazine? |
- max dose is 10mg Simvastatin |
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what statins can be taken anytime of the day? |
Crestor, Lipitor, Livalo, Lescol XL and Pravachol can be taken at any time of day. |
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generic for Vytorin? |
simvastatin + ezetimibe |
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Which of cholesterol-lowering drug classes require liver enzyme monitoring at baseline due to a risk of hepatotoxicity? |
Niacins, statin, and the fibrates could possibly cause liver damage and liver enzymes should be monitored. |
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SE of Niacin? |
- increase blood sugar - increase in uric acid - flushing |
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Which lipid lowering therapy is contraindicated in a patient with active peptic ulcer disease? |
Niaspan |
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generic for Repatha? |
evolocumab |
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brand for mipomersen? |
- Kynamro (CI in Hepatic disease or moderate to severe hepatic impairment) |
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A patient is started on Lipitor 20 mg daily. According to the ACC/AHA Blood Cholesterol Guidelines, when should the lipid panel be checked? |
in 4-12 weeks |
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what fibrate has the highest risk of myopathy when combine with statin? |
- Lopid (gemfibrozil) |
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What is the mechanism of action of alirocumab? |
Inhibits LDL receptor degradation allowing LDL to bind to the receptor on hepatocytes |
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brand for lomitapide? |
Juxtapid |
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what about lomitapide (Juxtapid)? |
- pregnancy X - indicated for homozygous familial hypercholesterolemia - box warning of hepatotoxicity |
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what statin has the least potent? |
fluvastin |
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Which lipid lowering therapy is contraindicated in patients with a history of gallstones? |
fibrates |
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MOA of fenofibrates? |
Fenofibrates are peroxisome proliferator alpha activators. |
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what other names niacin known by? |
- B3 - nicotinic acid |