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Answer updated on: 12 Feb 2020
It has many drug interactions(D) is the true statement here. Drug interactions are a major concern for bosentan. It is a substrate of 3A4 (many, many drugs) and 2C9. On top of that, it is an autoinducer, meaning that it induces its own metabolism. There are contraindcations for bosentan including cyclosporine (3A4) and glyburide due to hepatotoxicity. Warfarin also has a decreased effect due to ...
Answer updated on: 12 Feb 2020
There is a cure for PAH(C) is the false statement here. There is actually no cure for PAH. While there are medications to help control the symptoms and provide life-saving therapies, there is still no cure.
(A) is true because vasoconstriction is emblematic of hypertension. Recall TPR in the lectures of regular hypertension.
(B) is also true.Vascular wall remodeling is especially ...
Answer updated on: 12 Feb 2020
The drug is selective(D) is the false statement and is important clinically. Epoprostenol is NOT selective.Because epoprostenol is not selective, other drugs, such as other vasodilators, antiplatelets, and anticoagulants, have interactions with epoprostenol. In essence, epoprostenol acts on regular blood vessels in addition to the pulmonary vessels. This causes systemic problems and that ...
Answer updated on: 12 Feb 2020
All of the above(E) correctly describes the adverse effects of niacin. The following explains why.
One of the major adverse effects of niacin is flushing. Prostaglandin synthesis mediated via nicotinic acid, which is coupled to cyclooxygenase. Prostaglandin D is released from macrophages and causes cutaneous vasodilation. This can be remedied with aspirin, ibuprofen, etc. Aspirin 81 mg PO is ...
Answer updated on: 12 Feb 2020
Agonize peroxisome proliferator-activated receptor alpha (PPARa)(B) is the correct answer here. Fibric acid derivatives are agonists of PPARa. The following will explain what that means.
PPARa is a transcription factor that will transmit signals to genes. The receptor is expressed in the liver, kidney, heart, and muscle. Stimulation of the receptor leads to increased expression of lipoprotein ...
Answer updated on: 12 Feb 2020
Triglycerides(A) is the correct answer. As you may recall, the idea of stimulating the PPARa is to reduce triglycerides. According to the Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial (VA-HIT) from 1999, the decrease of triglycerides from fibric acid derivatives was immense (31%).
HDL is actually increased due to Apo-I and Apo-II being activated.
LDL and VLDL are ...
Answer updated on: 12 Feb 2020
Bind to bile salts in the intestine(C) is the correct answer, as may have been evident from the class name. These drugs will bind to bile salts in the intestine. The drugs themselves are not absorbed. Bile salts are normally excreted in the bile and enter the intestine and then majorly recycled, conserving cholesterol. These resins will inhibit the recycling by binding to the bile salts and ...
Answer updated on: 12 Feb 2020
Decrease LDL(A) is the correct answer. BEcause the liver must compensate for the loss of cholesterol, it will increase the number of LDL receptors to take up more LDL particles.
(B) is technically true as well, but the decrease in LDL is honestly the most clinically important.
(C) is actually false, but the decrease in LDL is much more relevant.
(D) is a trick answer as lowering HDL is ...
Answer updated on: 12 Feb 2020
Decreased absorption of other drugs(B) is the correct answer. Because these are resins, they can bind to other drugs and decrease their natural absorption. This is a problem if the drug is already poorly absorbed. To account for this, other drugs should be taken 1 hour before or 4 hours after. This does include statins.
(A) is false because bile acid sequestrants are not absorbed and systemic ...
Answer updated on: 12 Feb 2020
Decreasing LDL(C) is the correct answer here. The key word is main. As mentioned before, the liver will up-regulate LDL receptors to take up more LDL particles, which will thus decrease the levels in the bloodstream. The effect is quite nice (20-60%).
(A) is false because you wouldnt want to decrease HDL.
(B) is false because the HDL-raising effect is quite minimal.
(D) is technically ...
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