medchem cholesterol

3\.

HMG CoA reductase and NADPH

what is hyperlipidemia an indicator of?

susceptibility to coronary heart disease (chd) or coronary artery disease (cad)

what is hyperlipedimia

elevated plasma levels of lipids

which of the following are long chain fatty acid esters of glycerol?

triglyceride

which of the following is true about trigylceride

stored in adipose tissues and are hydrolyzed by lipases to free fatty acids (FFAs) when needed for energy

what are the 4 things found in plasma combined with lipoproteins?

triglyceride

which of the following primarily transports triglycerides?

VLDLS and chylomicrons

cholestrol is found in varying amounts in all -----

lipoproteins

which of the following is cholesterol a crucial building block of?

cell walls

bile acids

core structure of steroidal hormones

daily requirement of fresh cholesterol

(probably not gonna ask)

0\.9 - 2g

how much cholesterol is ingest through diet

35 percent

how much cholesterol is biosynthesised in the body?

65 percent

t/f majority of cholesterol comes from biosynthesis

t

t/f majority of cholesterol comes from your diet

f

which of the following forms a container for steroid and fats to travel through the plasma

apolipoprotein B-100 and phospholipids

what serves as a a carrier/transported for cholesterol due to its high lipophilicity?

lipoproteins

t/f highly lipophilic steroids are insoluble in blood plasma

t

which of the following of true about LDL

serves as a reservoir for cholesterol that be disintegrated by cells in demand of fresh cholesterol

which of the following is true for HDL?

collects cholesterol for transport to the liver but also the kidneys, ovaries, and testes

which of the following is unstable and can be easily oxidized

LDL

what is the ratio of protein to fats/cholesterol/lipid for LDL?

low ratio of protein to fats/cholesterol/lipids

what is the initial phase of plaque formation

LDL

what is ratio of proteins to fats/cholesterols/lipids for HDL?

high ratio of protein to fats/cholesterol/lipids

what is this the structure of

cholesterol

which of the following is true about LDL? small

there is a formation of foam cells (fat-laden macrophages)

t/f LDL has a low density of lipids to protein

f

during cholesterol biosynthesis, what does 3-hydroxy-3-methylglutaryl CoA turn into?

mevalonic acid

what does 3-hydroxy-3-methylglutaryl CoA undergo to form mevalonic acid

HMG-CoA reductase and 2 NADPH

what structure is this?

mevalonic acid

what structure is this?

coenzyme A

what is the enzyme in the mevalonate pathway and the cofactor

HMG-CoA reductase

2 NADPH

which of the following undergoes hydrolysis

red

what are the cholesterol derivatives?

cholic acid

estradiol

cortisone

testosterone

vitamin D

which of the following cholesterol derivative is this?

cholic acid

which of the following cholesterol derivative is this?

testosterone

which of the following cholesterol derivative is this?

estradiol

which of the following cholesterol derivative is this?

cortisone

what is beleived to be the primary problem lipid in CHD?

cholesterol

how much cholesterol should u have in your diet

\~300mg/day

how much cholesterol is biosynthesized in one day?

\~1gm/day

what drug class inhibit intestinal reabsorption if bile acids?

bile acid sequestering agents

what drug inhibits triglyceride biosynthesis and VLDL formation?

niacin

what drug inhibits dietary absorption of cholesterol

ezetimibe

what stimulates triglyceride cleavage and clearance?

fibrates

what drugs inhibiting cholesterol biosynthesis

3-hydroxy-3-methylglutaryl CoA reductase inhibitors: HMGR: statins

which of the following is a cholesterol reducer?

PCSK9 inhibitors

therapeutic approaches to treatment of hyperlipidemia

\-inhibit intestinal reabsorption of bile acid (bile acid sequestering agents)

\-inhibiting triglyceride biosynthesis and VLDL formation (niacin)

\-inhibiting dietary absorption of cholesterol (ezetimibe)

\-stimulating triglyceride cleavage and clearance (fibrates)

\*\*-inhibiting cholesterol biosynthesis (3-hydroxy3-methylglutaryl CoA reductase inhibitors: HMGR: statins)

LDLD cholesterol reducers (PCSK9 inhibitor)

what are all of the lipid lowering agents

\-bile sequestering agents

\-niacin

\-fibric acids

\-statin-HMG-coA reductase inhibitors

\-Cholesterol absorption inhibitors

\-LDL-cholesterol reducer (PCKL9 antibody)

which of the following are bile sequesters

cholestyramine,

colestipol

colesevelam

which of the following are anion exchange resins

bile sequestrants

which of the following is true about bile sequestrants?

they are water insoluble, inert to digestive enzymes and not absorbed

describe anion-exchange resins

bile acids is acidic/anionic. it is ten trap with resins that are basic/cationich

which of the following is a copolymer of polystyrene and divinylbenzene contain \~4meq of quaternary ammonium groups/gram?

cholestyramine

what functional group does cholestrymaine have

quaternary ammonium: N with 4 groups attached and (+) charge

which of the following is true about cholestryramine

it causes one gram resin to bind to 2 grams of bile acid

which of the following is a copolymer of diethylenetriamine and 1-chloro-2,3-epoxypropane?

colestipol

what functional group does colestipol have

tertiary amine: N with 3 groups attached and no charge

Which of the following is true about colestipol

it binds to less than 2 gram of bile acids/gm depending upon the pH of the intestinal tract

which of the following is a poly(allylylamine hydrochloride) cross-linked with epichlorohydrin and alkylate with 1-bromodecane and (6-bromohexyl)- trimethylammonium bromide?

\
no way there asking this

colesevelam

what functional group does colesevelam have?

trimethylammonium bromide: N (+) with one H and three methyl groups with bromide negative charge

what is this

cholic acid

what important functional group is in this

carboxylic acid

what type of bile acid is this?

primary bile acid

what type of bile acid are these

conjugated bile acids

what important functional group do conjugated bile acid have

sulfonic acid

what drug is this

cholestyramine

what drug is this

colestipol

what drug is this

colessevelam

which of the following is true?

chloride anion is exchanged for carboxylate anion - anionic exchange

which of the following drugs require an acidic environment because it does not contain a positive charge

colestipol

which of the following is true about colestipol?

colestipol requires an acidic environment to gain a positive charge to be a bile sequestrant and bind to carboxylate anion

what is the moa of bile squestrants

bind biles salts in the intestinal tract thereby reducing their reabsorption and increasing their excretion in the feces, which requires the liver to increase synthesis of bile acid and increase in liver cholesterol synthesis

increased liver synthesis of cholesterol also

increases hepatic LDL-receptor synthesis

\
know increase LDL receptors makes it quicker to remove cholesterol from the body

what drugs causes drug interaction between bile sequestrants

NSAIDS,

anticoagulants,

valproic acids

furosemide

sulfonulureas

troglitizone

HMG-CoA reductase inhibitors

are bile sequestrants basic or acidic

basic - needs acidic envrionment but has drug interactions with acidic drugs

anion-exchange resins will tend to

bind anionic drugs i.e. acidic drugs ????

what cholesterol medication can bilesequestrant interact with

HMG-Coa reductase inhibitors - statins

which of the following decrease absorption of certain drugs by non-specific binding?

digoxin

tricyclic antidepressants

thiazide diuretics

benzodiazepines

corticosteroids

beta blockers

what is the recommendation when take cholestryramine or colestipol with drug that may interact

take 2 hours apart for most drug

what drug is this

niacin

which of the following is try about niacin

its named changed from nicotinic acid because it sounds similar to the poison nicotine

niacin is also called

vitamin b3

Niacin is biosynthesized from

tryptophan

what is found in NAD/NADP as a co-enzyme necessary for dehydrogenase reactions?

niacin

deficiency of niacin or tryptophan causes

pellegra

t/f HIGH doses of niacin lower triglyceride and cholesterol. VLDL and LDL are reduced but HDLs are increases. Nicotinamide is not active this way

t

which of the following is true about the MOA of Niacin

\-==inhibit lipolysis of stored triglycerides== in adipose tissue resulting in decreasing FFA,VLDLs and LDLs in plasma

\-==decreases liver triglyceride esterfication== by diacylglycerol acyltransferase (DAGAT) reducing VLDL particle side

==-increases lipoprotein lipase activity== hydrolysing triglyceride in VLDLS

what must be anionic to be an effective antihyperlipidemic

niacin

which of the following are side effects of Niacin

flushing and GI distress

what can significantly reduce flushing for niacin

extended release formulation

what is the drug interaction between statins and niacin?

increase myotoxicity including rhabdomyolysis

what is the drug interaction between anticoagulant and niacin

prolong bleeding time

what is this

nicotinic acid

what turns niacin into nicotonic acid

glycine conjugation

\
phase 2 conjugation?

where would the reaction occur to form nicotinuric acid

green - OH

where would the reaction occue to make N-methylnaicin

blue - N

what happens in all of these reaction with niacin metabolism?

phase 2 conjugation

what is this

N-methylnaicin

what is this

NAD

what are two different names of niacin

nicotinic acid and vitamin B3