Pharm Test 4

Question 1

atherogenesis pathway

Answer 1

• excess LDL gets sequestered underneath the intima of the artery
• WBC come in
• differentiate into macrophages (proinflammatory)
• Swallow up LDL
• proinflammatory-> releases things to oxidase LDL
• now oxidized LDL enters blood stream and antibodies are formed against it.
• Macrophage itself can’t break down cholesterol so macrophages build up. Called foam cells
• crystallization of the cholesterol inside of the foam cell makes them rupture
• INFLAMMATION= positive feed back
• when they all die it forms a calcified plaque

Question 2

cholesterol vs triglyceride

Answer 2

cholesterol is sterile molecule that is a precursor to- steroid hormones, cell membranes, vit. D

triglyceride form adipose tissue

Question 3

Denovo synthesis

Answer 3

decreased cholesterol in diet makes the liver compensate by increasing cholesterol
bc it is accustomed to high levels

Question 4

2 sources of cholesterol

Answer 4

80% liver
20% diet

Question 5

mevalonate pathway

Answer 5

precursor HMGcoa is turned into mevalonate molecule by HMGcoa reductase=Cholesterol after a series of steps
Done in the liver

Statins block HMGcoa reductase

Question 6

What are the different types of lipoproteins and their function?

Answer 6

• VLDL- turns into LDL
• LDL-bad; Transporter: excess gets stuck in arteries
• HDL-good; Scavenger of cholesterol to bring down cholesterol levels.

Question 7

Calculate the cholesterol risk ratio using the LDL:HDL ratio

Answer 7

LDL/HDL

Question 8

target level of LDL

Answer 8

<130

Question 9

target level of total cholesterol

Answer 9

<200

Question 10

target level of HDL in men

Answer 10

> 40

Question 11

target level of HDL in women

Answer 11

> 50

Question 12

target level of triglycerides is

Answer 12

<120

Question 13

familial hypercholesterolemia is the most common(primary) cause of

Answer 13

hyper cholesterol

Question 14

secondary causes of hypercholesterolemia

Answer 14

things that cause increases in cholesterol: diabetes, alcohol etc.

primary is familial

Question 15

omega 3 fatty acids are good for

Answer 15

lowering cholesterol

Question 16

statin

Answer 16

• # 1 class for dyslipidemia
• HMGcoa reductase inhibitor
• put on it d/t high cholesterol and MI
• statin increase PCSK9

not for pregnant women
baby needs cholesterol and mom needs it to make breast milk

Question 17

Side effects of statin

Answer 17

CK elevation
muscle pain/weakness-most common reason why people stop drug

Question 18

Niacin

Answer 18

• AKA Vit. B3
• prevents VLDL from turning into LDL

Question 19

Niacin side effects

Answer 19

cutaneous vasodilation which causes flushing

Question 20

fibrates

Answer 20

• increase breakdown of fat. This decreases VLDL

Question 21

fibrate examples

Answer 21

-fib-
gemfibrozil
fenofibrate

Question 22

examples of bile acid bind resin BABR

Answer 22

Choles-
Cholestyramine
Cholestipol

Question 23

Absorption inhibitor MOA

Answer 23

block NPC1L1 transporter from transporting cholesterol from the bile acid into the body

Question 24

Absorption inhibitor example

Answer 24

Ezetimibe

Question 25

side effects of Absorption inhibitor

Answer 25

possible atrial wall thickening?

Question 26

MAB- PCSK 9 inhibitors are never given

Answer 26

alone, always with a statin **Lowers LDL by 65% if given with statin**

Question 27

side effects of MAB- PCSK 9 inhibitor

Answer 27

Risk of hypocholesterolemia

Question 28

PCSK9 pathway

Answer 28

* PCSK9 binds to LDL-r. Goes into clatherin coated pit. Receptor is now marked for destruction by the lysosome. This leads to a decrease in LDL-r less cholesterol being taken in d/t limited receptors=more in bloodstream statin increase PCSK9

Question 29

PCSK9 example

Answer 29

Evolocumab

Question 30

risks of low cholesterol

Answer 30

cancer hemorrhage stroke preterm and low birthweight decrease wound healing