Cholestyramine, colesevelam, and colestipol
Bile acid resins
Lowers ONLY cholesterol
Bile acid resins
Enhance hepatic conversion of cholesterol to bile acids
Bile acid resins
Bile acids have negative feedback on _________, rate limiting enzyme
7alpha-hydroxylase
Bile acid resins ______ # of hepatic LDL receptors
Increase
Bile acid resins _______ form must be mixed with liquids and taken with a meal
Powder
GI side effects most common. Interfere with absorption of fat soluble vitamins and/or drugs. Other drugs must be taken 1 hour before or 4 hours after
Bile acid resin
Bile acid resins ____ be used during pregnancy. Safe in children ___ or older
Can
6
HMG CoA reductase inhibitors are known as
Statins
Statins are ___________ inhibitors and they _____ hepatic LDL receptors
Competitive
Increase
All statins lower ______
Atorvastatin and Rosuvastatin also lower _________
Cholesterol
Triglycerides
Adversely elevates serum transaminases. Causes muscle weakness, myalgias, and dark brown urine. Associated with elevated CPK
Statins
Statins ____ be used in pregnancy/nursing mothers
Cannot
Rosuvastatin and Atorvastatin have longest ____ and can be taken at any time of day
Half life
Maximum endogenous cholesterol synthesis occurs at
Night
Fluvastatin, Lovastatin, and simvastatin have ______ and have to be taken at night
Short
All statins can be used after _____ years, pravastatin can be used after ______ yrs
10
8
____ increases Lovastatin absorption
Food
Food _______ absorption of pravastatin and pitavastatin
Decrease
Hyperlipidemia
Chol >
LDL >
Triglycerides >
240
160
200
Lovastatin and simvastatin are
Prodrugs
Rosuvastatin and fluvastatin
CYP2C9
Atorvastatin, Lovastatin, and Simvastatin. Avoid grapefruit
CYP 3A4
Inhibits cholesterol absorption at enterocytes of small intestine.
Ezetimibe