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31 Cards in this Set
- Front
- Back
Risk factors for chd |
men >45 yoa, women >55 yoa
smoking bp> 140/90 or on bp med HDL <40 Fam history of CHD -1 factor if HDL > 60 |
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LDL Goals
high risk CHD 10 yr risk >20 % moderately high risk >2 R.F. |
<100
<130 if moderate risk CHD |
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meds used to target LDL
meds used to target HDL Meds used to target TG |
LDL- Statins
HDL- fenofibrates and Niacin TG- exercise 1st, if >500 use fish oil or fenofibrates |
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Statins
MOA Class CI Class SE Class notes |
inhibit the enzyme, HMG-COa reducatase and enzyme needed to make cholesterol
CI- Acute liver dx, need CPK checked SE- Myalgias, myopathy, rhabadomyolysis, cognitive impairment, increased BG, Preg Cat X |
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atorvastatin
brand equiva dosd |
Lipitor
10mg, given any time of day do not need to use lower doses if crCl <30 |
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simvastatin
brand dose equiv when to give |
Zocor
vytorin- simva/ ezetimibe 20 mg equiv take QHS |
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Rosuvastatin
brand equiv dose when to take |
Crestor
5mg take any time of day |
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pravastatin
brand dose equiv when to take |
pravachol
40mg tk any time |
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lovastatin
brand equiv dose |
mevacor
40mg with meal altoprev- ER form is taken at bedtime |
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fluvastatin
brand equiv dose when to give |
lescol
80 mg at bedtime |
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pitavastatin
brand dose equi when to give |
livalo
2mg take any time of day |
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ezetimibe
brand MOA decreases how much of what |
zetia
inhibits absorption of cholesterol from small intestine decreased LDL 20% increases HDL 3% decreases TG 10% |
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Bile acid sequestrants
MOA actions SE Preg cat |
binds bile acids in intestines, removing biles acid from recirculation
dec LDL 10-30% increases HDL 5% no change or may increase TG Welchol is Cat B SE- Constipation, abdominal pain, cramping, bloating |
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colesevelam
brand how to take |
welchol-also approved for DM2
take with meal AND full glass of water has less GI effects than other BAS |
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Fibrates
MOA |
PPAR alpha activators (note TZDs are PPAR-gamma agonists)
enhance elim of VLDL= dec TG AND increased HDL but TG are high to begin, decreasing TG will increase LDL |
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which fenofibrate is only one with indication for us with statin
|
Trilipix
|
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fenofibrates
brands and their strengths |
tricor-48 145
trilipix 45, 135 |
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gemfibrozil
brand |
lopid
do not use with statins, increases myopathy chance |
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which BAS can cause tooth decay
|
cholestryamine if sipped
|
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Niacins
MOA Effects SE |
decreases rate of VLDL synthesis and LDL
dec LDL 5-25%, increases HDL 15-35%, dec TG 20-50% SE- flushing, itching, diarrhea, GI, hepatotoxicity -monitor LFTs |
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whats in advicor and simcor
|
advicor= lovastatin + niasapan ER
Simcor= simvastatin + niasapan ER |
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separate Niacin from BAS for how long
|
4-6 H
|
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niasapan counseling
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take with small snack at bedtime
other niacins take with food pre-tx flushing with aspirin 325mg 30 mins before dose |
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Fish oils
MOA SE Preg cat |
may be due to reduced hepatic synth. of TGs up to 45%
adjunct for TG>500 SE- eructation (burping) dyspepsia Cat C |
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Omega3-fatty acids
brand could possibly do what to cholesterol |
Lovaza
could increase LDL by 44% |
|
icosapent ethyl
brand |
vascepa
no increase in LDL like lovaza |
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LDL equation
|
LDL= TC-HDL-TG/5
TG can not be >500 |
|
lopid
how to take |
600mg BID before breakfast and dinner
|
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which meds should be taken 4 h prior to welchol
|
phenytoin, levothyroxide, glyburide, and oral contraceptives
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|
whats in caduet
|
atorvastatin + amlodiplne
|
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which meds can dec TG by 10%
|
Fish Oil (FO)
Fenofibrates (FB) Niacin( Vitamin B) all have 2 letters= TG, 2 letters |