8. Cholesterol and Lipid Lowering

What is the brand name for atorvastatin?

Lipitor

What is the generic name for Lipitor?

Atorvastatin

What drug class is atorvastatin?

Statin (HMG-CoA reductase inhibitor)

What is the brand name for lovastatin?

Mevacor, Altoprev

What is the generic name for Mevacor?

Lovastatin

What is the generic name for Altoprev?

Lovastatin

What drug class is lovastatin?

Statin (HMG-CoA reductase inhibitor)

What is the brand name for pravastatin?

Pravachol

What is the generic name for Pravachol?

Pravastatin

What drug class is pravastatin?

Statin (HMG-CoA reductase inhibitor)

What is the brand name for rosuvastatin?

Crestor

What is the generic name for Crestor?

Rosuvastatin

What drug class is rosuvastatin?

Statin (HMG-CoA reductase inhibitor)

What is the brand name for simvastatin?

Zocor

What is the generic name for Zocor?

Simvastatin

What drug class is simvastatin?

Statin (HMG-CoA reductase inhibitor)

What is the brand name for ezetimibe/simvastatin?

Vytorin

What drugs are contained in Vytorin?

Ezetimibe and simvastatin

What drug classes are combined in Vytorin?

Cholesterol absorption inhibitor and statin

Which component of Vytorin is a statin?

Simvastatin

Which component of Vytorin is a cholesterol absorption inhibitor?

Ezetimibe

What common suffix identifies statins?

-statin

What enzyme do statins inhibit?

HMG-CoA reductase

What is the main lipid effect of statins?

Lower LDL cholesterol

What are statins primarily used for?

LDL reduction and cardiovascular risk reduction

What serious muscle adverse effect is associated with statins?

Myopathy and rhabdomyolysis

What severe muscle injury can occur with statins?

Rhabdomyolysis

What liver-related laboratory abnormality can occur with statins?

Elevated liver enzymes

What are the two major safety themes for statins?

Muscle toxicity and liver enzyme elevations

Which statins have especially important grapefruit interactions?

Simvastatin and lovastatin

Which other statin may be affected by grapefruit depending on the amount consumed?

Atorvastatin

Why can grapefruit be problematic with certain statins?

It can increase statin exposure and increase adverse-effect risk

Should two statins normally be used together?

No

Why should two statins not be duplicated?

It creates unnecessary therapeutic duplication and can increase toxicity risk

What is the memory key for statins?

-STATIN = HMG-CoA reductase inhibitor; mainly used for LDL reduction and cardiovascular risk reduction

Which drug matches Lipitor?

Atorvastatin — statin

Which drug matches Mevacor/Altoprev?

Lovastatin — statin

Which drug matches Pravachol?

Pravastatin — statin

Which drug matches Crestor?

Rosuvastatin — statin

Which drug matches Zocor?

Simvastatin — statin

Which drug matches Vytorin?

Ezetimibe/simvastatin — cholesterol absorption inhibitor plus statin

Which lipid-lowering drug class is associated with myopathy and rhabdomyolysis?

Statins

Which lipid-lowering drug class is associated with liver enzyme elevations?

Statins

Which two statins in this section have the most important grapefruit interaction?

Simvastatin and lovastatin

What is the brand name for ezetimibe?

Zetia

What is the generic name for Zetia?

Ezetimibe

What drug class is ezetimibe?

Cholesterol absorption inhibitor

What is the main action of ezetimibe?

Blocks intestinal cholesterol absorption

What is the brand name for fenofibrate?

Tricor

What is the generic name for Tricor?

Fenofibrate

What drug class is fenofibrate?

Fibrate

What is the main lipid effect of fibrates?

Lower triglycerides

What is the brand name for gemfibrozil?

Lopid

What is the generic name for Lopid?

Gemfibrozil

What drug class is gemfibrozil?

Fibrate

What lipid level do gemfibrozil and fenofibrate primarily lower?

Triglycerides

What important interaction occurs between gemfibrozil and statins?

Increased risk of myopathy

Why can combining gemfibrozil with a statin be dangerous?

It can significantly increase the risk of muscle toxicity and myopathy

Which fibrate has an especially important interaction with statins?

Gemfibrozil

What is the brand name for omega-3-acid ethyl esters?

Lovaza

What is the generic name for Lovaza?

Omega-3-acid ethyl esters

What drug class is omega-3-acid ethyl esters?

Omega-3 fatty acid lipid-lowering agent

What is the brand name for niacin ER?

Niaspan

What is the generic name for Niaspan?

Niacin ER

What drug class is niacin ER?

Lipid-lowering agent

What does ER mean in niacin ER?

Extended release

What common adverse effect is associated with niacin?

Flushing

What liver-related toxicity can occur with niacin?

Hepatotoxicity

What effect can niacin have on blood glucose?

It can increase or worsen blood glucose

What effect can niacin have on uric acid?

It can increase uric acid

Which lipid-lowering drug commonly causes flushing?

Niacin

Which lipid-lowering drug can cause flushing, hepatotoxicity, and changes in glucose and uric acid?

Niacin

What is the brand name for alirocumab?

Praluent

What is the generic name for Praluent?

Alirocumab

What drug class is alirocumab?

PCSK9 inhibitor

What is the brand name for evolocumab?

Repatha

What is the generic name for Repatha?

Evolocumab

What drug class is evolocumab?

PCSK9 inhibitor

Which drugs in this section are PCSK9 inhibitors?

Alirocumab and evolocumab

What is the main lipid effect of PCSK9 inhibitors?

Lower LDL cholesterol

How are PCSK9 inhibitors administered?

Subcutaneous injection

Are PCSK9 inhibitors oral or injectable medications?

Injectable medications

How are PCSK9 inhibitors commonly stored?

Refrigerated

Should PCSK9 inhibitors be frozen?

No

What type of products are PCSK9 inhibitors?

Subcutaneous specialty products

What is the memory key for non-statin lipid drugs?

Ezetimibe blocks cholesterol absorption; fibrates lower triglycerides; PCSK9 inhibitors are injectable LDL-lowering drugs

Which drug matches Zetia?

Ezetimibe — cholesterol absorption inhibitor

Which drug matches Tricor?

Fenofibrate — fibrate

Which drug matches Lopid?

Gemfibrozil — fibrate

Which drug matches Lovaza?

Omega-3-acid ethyl esters — omega-3 lipid-lowering agent

Which drug matches Niaspan?

Niacin ER — lipid-lowering agent

Which drug matches Praluent?

Alirocumab — PCSK9 inhibitor

Which drug matches Repatha?

Evolocumab — PCSK9 inhibitor

Which lipid-lowering drug blocks cholesterol absorption?

Ezetimibe

Which lipid-lowering drug classes primarily lower triglycerides?

Fibrates

Which two fibrates are in this section?

Fenofibrate and gemfibrozil

Which lipid-lowering drugs are injectable PCSK9 inhibitors?

Alirocumab and evolocumab

Which lipid-lowering drugs should generally be stored refrigerated and never frozen?

PCSK9 inhibitors such as alirocumab and evolocumab

Which lipid-lowering drug has an important myopathy interaction with statins?

Gemfibrozil

Which lipid-lowering drug is especially associated with flushing?

Niacin