med chem test 3

  1. a complex disorder with no single factor as the cause
    metabolic syndrome
  2. 2 main characteristics of metabolic syndrome
    • abdominal obesity
    • insulin resistance
  3. 4 metabolic risk factors for metabolic syndrome
    • atherogenic dyslipidemia
    • hypertension
    • high plasma glucose
    • a prothrombic and pro-inflammatory state
  4. major cause of death in the western world
    vascular disease dominated by artherosclerotic heart disease
  5. the obvious indicator for susceptibility to plaque buildup
  6. 5 causes of hyperlipidemia
    • diet
    • liver disease
    • kidney disease
    • pancreas disease
    • thyroid disease
  7. degenerative changes in the intima of medium and large vessels
  8. 2 characteristics of artherosclerosis
    • plaque
    • decrease lumen diameter
  9. what leads to the lipid rich core of plaque
    • inflammation
    • macrophage activation
  10. intraplaque thrombus
    stable angina
  11. mural thrombus
    unstable angina
  12. occlusive thrombus
    acute myocardial infarction
  13. macromolecules that consist of triglycerides and cholesterol non-covalently associated with protein and carbohydrates
  14. natural molecule of lipid
    cis fatty acids
  15. produced by partial hydrogenation of unsaturated oils, margarines, vegetable shortening, frying oils
    trans fatty acids
  16. what is the implication of trans fat
    elevated LDL
  17. their source is exogenous fat in the diet
    90% triglycerides by weight
  18. their source is the liver
    60% triglycerides
  19. rapidly produced from chylomicrons and VLDL
  20. major cholesterol carrying protein
    50% cholesterol and 10% triglycerides
    major concern in hyperlipidemic states and diseases
  21. 25% cholesterol and 50% protein and accounts for 17% of serum cholesterol
  22. type of hyperlipoproteinemia with abnormal amounts of chylomicrons resulting in plasma with a creamy top
    massive elevated triglycerides
  23. no drugs to treat this type of hyperlipoprotein, treat by decreasing dietary fat
  24. cause of this type of hyperlipoproteinemias is decrease in lipoprotein lipase that clears plasma of chylomicrons
  25. type of hyperlipoprotein with elevated beta-lipoproteins and LDL
    normal triglycerides
    heavily elevated total cholesterol
    clear plasma
  26. type of hyperlipoproteinemia with elevated pre-beta-lipoproteins and LDL+VLDL
    triglycerides slightly elevated
    heavily elevated total cholesterol
    slightly turbid plasma
  27. type of hyperlipoproteinemia that is very common
    familial autosomal dominant abnormality often expressed at infanct
  28. type of hyperlipoproteinemias that cause appears to be disturbed catabolism of LDL
  29. type of hyperlipoproteinemia with heavily elevated beta-lipoproteins
    abnormal VLDL/LDL compostion
    elevated trilycerides and total cholesterol
  30. type of hyperlipoproteinemia that is rare
    familial inheritance
  31. type of hyperlipoproteinemia that is treated with dietary restrictions and drugs
    all but type I
  32. type of hyperlipoproteinemia with elevated pre-beta-lipoproteins and VLDL
    moderate to heavy elevated triglycerides
    normal to elevated total cholesterol
    turbid plasma
  33. type of hyperlipoproteinemia that has an unknown metabolic defect
  34. type of hyperlipoproteinemia with elevated pre-beta lipoproteins with chylomicrons present
    VLDL elevated
    massively elevated TG
    slightly elevated total cholesterol
    turbid plasma with floating layer of chylomicrons
  35. type of hyperlipoproteinemia with a metabolic defect unknow however clearance of dietary fat is impaired
  36. 3 general considerations when considering how to approach antihyperlipidemic agents
    • identify the type of hyperlipidemia
    • estabish baseline cholesterol
    • institute revised diet, weight loss, and increased physical activity
  37. 5 drug therapy approaches for hyperlipidemia
    • first choice drugs (statins or HMG-CoA reductase inhibitors
    • consider ERT
    • combination drug therapy
    • fibric acid type of drugs
    • thyroid hormone - drugs of last resort
  38. why are fibric acids and HMG-CoA reductase inhibitors not recommended
    • myopathy
    • rhabdomyolysis
    • renal failure
  39. rate limiting step in the synthesis of cholesterol
    HMG-CoA reductase
  40. generally accepted that lowering of cholesterol levels is best accomplished by
    reducing LDL levels
  41. what 2 means do HMG-CoA reductase inhibitors contribute to lowering of LDL
    • decreased cholesterol synthesis by blocking the HMG-CoA reductase active site
    • leads to an increase hepatic LDL receptros causing increase processing of plasma LDL
  42. why are statins contraindicated in pregnancy
    you need cholesterol to build little johnny's cells
  43. side effect of statins
  44. can you drink alcohol when on statins
  45. lipophilic statins
    • atorvastatin
    • lovastatin
    • simvastatin
  46. which statins are more hydorphilic
    • pravastatin
    • rosuvastatin
    • fluvastatin
  47. what happens when cholesterol levels drop below 100mg/dl
    anxiety and clinical depression
  48. this is used as a starting material for statin class synthesis and is isolated from penicillium citrinum
  49. a naturally occuring lipid-soluble, vitamin like substance found in the inner mitochondrial anc cellular membranes and in blood
    CoEnzyme Q10
  50. in what sense can fibrates be used cardiovascularly
    reduce the occurence of nonfatal MI but have no significant effects on other adverse CV outcomes
  51. new mechanism by which fibrates may act
    T1Rs inhibition
  52. gene mutation that can have an affect on statin induced myopathy
    SLCO1B1 - a gene that encodes for the protein involved in the transport of statins from the blood into the liver
Card Set
med chem test 3