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What is the mechanism for Cholestyramine?
Bind bile acids in GI = low absorption, increased production (take just before meals)
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What is the mechanism for Colesevelam?
Bind bile acids in GI = low absorption, increased production (take just before meals)
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What is the mechanism for Colestipol?
Bind bile acids in GI = low absorption, increased production (take just before meals)
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What is the mechanism for Lovastatin?
HMG-CoA reductase inhibition (competitive)
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What is the mechanism for Simvastatin?
HMG-CoA reductase inhibition (competitive)
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What is the mechanism for Atorvastatin?
HMG-CoA reductase inhibition (competitive)
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What is the mechanism for Rosuvastatin?
HMG-CoA reductase inhibition (competitive)
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What is the mechanism for Pravastatin?
HMG-CoA reductase inhibition (competitive)
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What is the mechanism for Fluvastatin?
HMG-CoA reductase inhibition (competitive)
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What is the mechanism for Ezetimibe?
Decreased absorption of Cholesterol at brush border
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What is the mechanism for Niacin?
Decreased VDL synthesis
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What is the mechanism for Laropiprant?
Prostaglandin D-2 antagonist
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What is the mechanism for Gemfibrozil?
Insulin-like PPARa induction of genes resulting in decreased VDL synthesis and increased VDL catabolism (up HDL by increasing apoA-1/2)
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What is the mechanism for Fenofibrate?
Insulin-like PPARa induction of genes resulting in decreased VDL synthesis and increased VDL catabolism (up HDL by increasing apoA-1/2)
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What is the mechanism for Fish Oil?
Suppresses VLDL production
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What are indications for Bile Acid Binding Resins?
Heterozygous familial hypercholesterolemia, combined hyperlipidemia
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What are indications for Statins?
Familial hypercholesterolemia, combined hyperlipidemia
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What are indications for Niacin?
Heterozygous familial hypercholesterolemia, combined hyperlipidemia, dysbetalipoproteinemia, etc.
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What are indications for Laropiprant?
Flushing induced by Niacin
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What are indications for Fibrates?
Moderate & severe Familial Hypertriglyceridemia, others
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What are indications for Fish Oil?
All patients (?)
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What are side effects of bile acid binding resins?
Constipation, bloating, gallstones (rare) and steatorrhea (rare) (colesevelam is best tolerated)
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What are side effects of Statins?
Hepatotoxicity, myopathy, rhabdomyolysis in high doses, NEVER given to pregnant women
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What are side effects of Niacin?
Flushing TX
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What are side effects of Fibrates?
(Rare) skin rash, GI Sx, myopathy - rhabdo when combined with statins, anemia, Gall stones
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What are drug interactions of bile acid binding resins?
Interferes with absorption: digitalis, thiazides, beta blockers, warfarin, fat soluble vitamins (K)
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What are drug interactions of Lovastatin?
Grapefruit/Verapamil inhibit CYP3A4 = increases conc of statins
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What are drug interactions of Simvastatin?
Grapefruit/Verapamil inhibit CYP3A4 = increases conc of statins
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What are drug interactions of Atorvastatin?
Grapefruit/Verapamil inhibit CYP3A4 = increases conc of statins
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What are drug interactions of Rosuvastatin?
No CYP3A4 interactions
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What are drug interactions of Pravastatin?
No CYP3A4 interactions
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What are drug interactions of Fluvastatin?
No CYP3A4 interactions
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What are drug interactions of Fibrates?
Potentiates coumarin (warfarin), indanedione anticoagulants
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