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Which is the strongest statin?
Rosuvastatin (Crestor.)
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What's the brand name of Simvastatin?
Zocor.
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What's the brand name of Atorvastatin?
Lipitor.
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What's the brand name of Pravastatin?
Pravachol.
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What's the brand name of Lovastatin?
Mevacor, Altoprev.
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What's the brand name of Fluvastatin?
Lescol.
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Statins are best for lowering which lipid marker?
LDL (by 18-55%)
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Which class of drugs raises HDL the most (by 15-35%)?
Nictoinic acid.
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Which 2 classes are used to lower TG (by 20-50%)
Nicotinic acid and Fibric acids.
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Name 2 fibric acids.
Gemfibrozil, Fenofibrate
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What are the top 2 side effects of statins?
Myopathy, increased liver enzymes.
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What is a top side effect of bile acid sequestrants?
GI distress (nausea/constipation)
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What is a 3 side effects of nicotinic acid?
- Flushing, hyperglycemia, hyperuricemia
- (also hepatotoxicity)
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What is a 3 side effects of fibric acids?
Dyspepsia, gallstones, myopathy.
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Which 2 classes of lipid drugs have possible side effect of myopathy?
Statins, fibric acids.
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Which 2 classes of lipid drugs have possible side effect of hepatotoxicity?
Statins, nicotinic acids.
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Which class of lipid drugs have possible side effect of gallstones?
Fibric acids
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Which class of lipid drugs is contraindicated in severe gout?
Nicotinic acids
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What's the brand name of Gemfibrozil?
Lopid.
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Which class is Trilipix in? What's the generic name?
- Class: Fibric acids.
- Name: Fenofibric acid.
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Which 2 drugs does Vytorin combine?
Ezetimibe and simvastatin.
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What's the brand name of Ezetimibe?
Zetia.
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Which drug blocks absorption of cholesterol in the gut?
Ezetimibe (Zetia)
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Which drug combines a Cholesterol absorption inhibitor with a statin?
Vytorin.
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Which drug is a combo of Zetia/Zocor?
Vytorin.
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What is the brand name of Pitavastatin?
Livalo.
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What's the name for Welchol?
Colesevelam.
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What class of drug is Welchol?
Bile acid sequestrant.
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What are 3 bile acid sequestrants?
Cholestyramine, Colestipol, Colesevelam.
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Which is the only fibrate approved to be used with statins?
Trilipix.
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Name the top 3 strongest statins by generic name.
Rosuvastatin, Atorvastatin, Simvastatin
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Name the top 3 strongest statins by brand name.
Crestor, Lipitor, Zocor
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What time of day are statins usually taken? Why?
At night, because liver makes more cholesterol at night.
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Which statin is best taken with food?
Lovastatin (Mevacor)
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What is the cholesterol/HTN combo drug?
Caduet (amlodipine/atorvastatin).
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What's Simcor a combination of?
Niaspan and Simvastatin.
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What class of HTN drug and lipid drug does Caduet
have?
CCB and statin.
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Which class can actually increase triglycerides?
Bile acid sequestrants
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What is Tricor?
Fenofibrate.
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When should you check LFTs after starting a statin? What levels would be indication to stop?
1st baseline, and Monitor 12 weeks after starting. D/C if LFTs are> 3x upper limit of normal.
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What class of meds have been reported to increase risk of DM?
Statins (possobly by increasing insulin resistance in tissues.
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Which 3 Statins are CYP3A4 metabolized?
- Lipitor, Mevacor, Zocor but least with Lipitor
- ALS (atorv, lova, simva)
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What drugs do you have to be careful with those statins that are CYP3A4 metabolized because of increased myopathy/ rhabdo risk? (5x higher for strong inhibitors)
Amiodarone, azole antifungals, CCBs, cyclosporine, fibric acids, grapefruit juice, niacin, nefazodone, protease irnhibitors, macrolides
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What heart drugs do you have to be careful with those statins that are CYP3A4 metabolized because of increased blood levels
Digoxin (20% higher)
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Which other cholesterol drug lowers bioavailability of statins?
Bile acid sequestrants
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Which statins are not really metabolized by the p450 system?
Rosuvastatin, pitavastatin, pravastatin
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Which Statin is CYP2C9 metabolized?
Fluvastatin (Lescol)
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Which macropods least likely to interact with statins?
Azithromycin
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What are drugs that increase triglycerides?
Oral estrogens, atypical antipsychotics, beta-blockers, thiazides, protease imhibitors
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When initiate drug therapy for TG?
When > 200 w/ high LDL or over 500 , esp w/ Hx of pancreatitis (focus on diet + wt loss initially)
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