Question 1

When a patient is intolerant to statin class drugs, the most common second choice for treating LDL cholesterol levels greater than 135 mg/dl is:&#10;A) Bile acid sequestrants&#10;B) Fibric acid derivatives&#10;C) Cholesterol absorption inhibitors&#10;D) Niacin&#10;E) Statins

Accepted Answer

Fibrates are the second-best choice given a statin intolerance. Fibrates in combination with other class drugs are commonly used.

Question 2

Isolated hypertriglyceridemia is best treated with:&#10;A) Statins&#10;B) Fibric acid derivatives&#10;C) Cholesterol absorption inhibitors&#10;D) Niacin&#10;E) Bile acid sequestrants

Accepted Answer

Fibrates are particularly well suited to lower triglycerides. Actual percentage of lowering depends on the starting plasma levels.

Question 3

Vytorin is a combination of ezetimibe and simvastatin. The pharmacologic effects include:&#10;A) Platelet inhibition&#10;B) Reduction in intestinal absorption of cholesterol&#10;C) Cholesterol-lowering ability independent of plasma lipoprotein levels&#10;D) Inhibition in cholesterol synthesis within hepatocytes&#10;E) A, B, and D

Accepted Answer

Ezetimibe functions to reduce cholesterol absorption in the small intestine. Simvastatin is an HMG CoA reductase inhibitor with many actions including reduced hepatocyte cholesterol synthesis, decreased platelet adhesion, and enhanced vascular endothelial function.

Deck 25: Lipid-Lowering Drugs and Atherosclerosis