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MeganM
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Secondary dyslipidemia causes.
- DM
- hypOthyroidism
- obstructive liver disease
- CRF
- pharmaceuticals
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Screening for hyperlipidemia should begin at what age for kids with a positive fam h/o hyperlipidemia?
2 yo
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All children, regardless of fam hx, should be routinely screened for hyperlipidemia at what ages?
- between 9-11 and
- 17-21 yrs
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Very high LDL, > ______ is often genetic. Very high triglycerides, > ______ are due to other diseases and meds
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For pts with polypharmacy or with major concerns about liver fun, which statins are a good choice?
- prava-
- flu-
- or rosuvastatin
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_________statin is available free in some areas.
atorva
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When are bile acid sequestrants CI?
- elevated TG (esp > 400)
- dysbetalipoproteinuria
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SE of bile acid sequestrants.
- GI distress/constipation
- decreased absorption of other meds
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What are some bile acid sequestrants?
- cholestyramine
- colestipol
- colesevelam
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Major action of bile acid sequestrants.
block cholesterol absorption
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How should you start a med of nicotinic acid?
lower dose 1-2 x daily, EXR
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When should you advise a pt to take Niaspan nicotinic acid?
with ASA or NSAID before bedtime to reduce temp flushing sensation
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When is nicotinic acid CI?
- liver dz
- severe gout
- peptic ulcer
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SE of nicotinic acid.
- flushing
- hyperglycemia
- hyperuricemia
- upper GI distress
- hepatotox
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Major axn of nicotinic acid.
decreases production of TG and VLDL
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CI for fibrates.
severe renal or liver dz
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SE of fibrates.
- dyspepsia
- gallstones
- myopathy
- increased risk of rhabdo w/ statins
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A benefit of _________ is that they reduce progression of coronary lesions.
fibrates
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Fibrates are primarily used to _______.
decrease TG
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_________ selectively absorb cholesterol from the small intestines.
- cholesterol absorption inhibitors
- Ezetimibe (Zetia)
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cholesterol absorption inhibitors like Ezetimibe (Zetia) are potentiated by ________ and ________.
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SE of cholesterol absorption inhibitors such as Ezetimibe (Zetia).
- diarrhea, abd pain
- increased LFTs
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________ reduce LDL and apoB lipoprotein.
- cholesterol absorption inhibitors
- Ezetimibe (Zetia)
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__________ inhibit synthesis of VLDL in liver and lower TG 20-30%.
omega 3s
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Who benefits from high dose statins?
Individuals with known _________ or with LDL-C > ______.
Age 40-75 who have ______ and LDL ___ - _____,
or those with 10 year ASCVD risk > _____.
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High intensity statin therapy include statins that lower LDL-C by how much? What are specific examples?
- > 50%
- atorvostatin, rosuvostatin
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High intensity statin therapy should be initiated when?
- DM with 10 year ASCVD risk 7.5% or higher
- Anyone 40-75 yo with 7.5% or higher 10-yr risk of ASCVD (mod to high intensity statin)
- LDL-C > or = 190mg/dl (mod or high intensity statin)
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What are some things that negatively affect cholesterol?
- steroids
- progesterone
- anti-psychotic meds
- testosterone
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ATP guidelines state that _____ is a CHD risk equivalent.
DM
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With DM, the 10-year risk for development of CHD increases how much?
20%
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