1. What is
What are the toxicities of NIACIN
HYPERTRIGLYCERIDEMIA? And
what are the forms of Management
of the condition?
It is a severe lipemia with
triglyceride of 200-300mg/dl
Patients Develop: Eruptive
xanthomas, hepatomegaly,
hyperplasia, lipid foam in
bone marrow, liver & spleen
Mgt: Niacin/Fibrates/Marine
omega-3
2. What are the GENETIC conditions
characteristics of HDL deficiency?
GENETIC DISORDER
I. Tangiers disease
II. Lecithin Cholesterol
Acyltransferase Deficiency
III. Familial-alpha-
lipoproteinemia-all decrease
HDL levels
3. What is the role of FIBRIC ACID
DERIVATES OR FIBRATES?
Gemfibrozil, Fenofibrate (Fibrates)
Decrease secretion of VLDL
& increase lipoprotein lipase
activity
4. What are the different conditions
that belong to PRIMARY
HYPERCHOLESTEROLEMIA?
CONDITIONS OF PRIMARY
ELEVATED CHOLESTEROL:
1) Familial
hypercholesterolemia (TC=
260-500mg/dL)
2) Familial ligand Defective
apolipoprtein B-100
3) Familial combined
hyperlipoproteinemia (FCH)
4) LpHyperlipoproteinemia
5) Cholesteryl Ester Storage
Disease
5.
use?
Toxicity of B3 vitamin
Cutaneous vasodilation
sensation
Acanthosis nigricans
insulin
Not for Peptic ulcer patients
Elevation of liver
aminotransferase
(Reversible)
Carbohydrate tolerance
Hyperuricemia (gout)
Blurring of distant vision
Birth defects (in animals)
6. When is the use of statins
CONTRAINDICATED? And what are
its TOXICITIES?
STATINS C.I. & TOXICITIES
Pregnancy category X
Children should be > 16y/o
Toxicity:
Increase serum
amminotransferase (esp in
alchol abuse)
Increase in creatine kinase
leading to MYOPATHY
7. What common disorder is
associated with increases incidence
of coronary disease?
(with inc. VDL/LDL or both)
FAMILIAL COMBINED
HYPERLIPOPROTEINEMIA (FCH)
INC. VDL/LDL or BOTH
Tx: Diet (not sufficient)
Reductase Inhibitor
(pravastatin/rosuvastatin) +
Niacin/fenofibrate = omega
3
8. What is HDL? What are its
benefits?
High density Lipoprotein
a.k.a. the good cholesterol
exert an anti atherogenic
effect; it secreted from the
liver & instestines
- Retrieves cholesterol
from arterial walls
Cigarette smoking &
Diabetes can decrease the
levels of HDL
11. Which drugs are members of 3-
Hydroxy-3methylglutaryl-coenzyme
A reductase inhibitors that
decreases LDL, vascular
inflammation and oxidative stress?
Hmg-CoA-Reductase
inhibitors Or
STATINS
Lovastatin, atorvastatin,
fluvastatin, pravastatin,
simvastatin, rosuvastatin
& pitavastatin

9. What are BILE ACID 12. What can be used to manage

familial dysbetalioproteinemia with
SEQUESTRANTS?
Colestipol, Cholestyramine & increase chylomicron remnants &
colesevalam VLDL?
- Binds bile acid in the An Increase in
GUT; prevents CHYLOMICRON
reabsorption; decreases remnants/VLDL/total
LDL cholesterol &triglyceride
can be managed by;
10. What are the desirable values of - Weight loss
HDL? Total cholesterol? LDL & - Decrease fat cholesterol
- Decrease alcohol intake
triglyceride?
- Use of fibrates/niacin
Measured in serum after 10 hours of
- Use of reductase
fasting
TOTAL CHOLESTEROL inhibitors
LDL
HDL (MEN) 13. What is the role of NIACIN in
HDL (WOMEN) lowering VLDL & LDL?
TRIGLYCERIDE NIACIN or vitamin B3
DESIRABLE (mg/dL) (not niacinamide)
<200 increases HDL & inhibits
<130 secreation of both VLDL
>40 & LDL.
>50 - Decreases triglyceride if
<120 combined with omega-3
BASED ON National Cholesterol - Can be used with resin or
Education program reductase inhibitors to
normalize LDL in most
forms of
hypercholesterolemia
14. What drug acts as STEROL TYPES:
ABSORPTION INHIBITOR? LDL
EZEMTIMIBE - Low density lipoprotein
- Blocks sterol a.k.a. bad cholesterol
transporter in intestines IDL
brush border - Intermediate density
- Inhibits reabsorption of lipoprotein (elevated
cholesterol excreted in triglyceride and
BILE cholesterol)
- Decreases LDL & VDL
phytosterols - Very low density
lipoprotein (elevated
15. When is the BEST TIME to take triglyceride)
STATINS?
- Cholesterol synthesis
occurs at NIGHT all
EXCEPT atorvastatin
and rosuvastatin
should bee given in the
EVENING (if SINGLE
DOSE)
- Absorption is
enchanced by FOOD
(except
PRAVASTATIN)
ROSUVASTATIN Is
most efficacious at 5-
40mg/d for server
hypercholesterolemia

16. What is APOLIPOPROTEIN B-

100? And what are its different
types?
APOLIPOPROETIN (APO) B-100
- Convey fats/lipids in
the artery wall resulting
to atherosclerosis