How Much Do You Know About Antidyslipidemic?

1. Six months after beginning atorvastatin, a patient's total and LDL cholesterol concentrations remained above normal, his physician decided to add ezetimibe. Which of the following is the most accurate description of ezetimibe's mechanism of an action?

Decreased lipid synthesis in adipose tissue

Decreased secretion of VLDL by the liver

Decreased gastrointestinal absorption of cholesterol

Increased endocytosis of HDL by the liver

Ezetimibe works by decreasing the absorption of cholesterol in the gastrointestinal tract. This means that less cholesterol is able to be absorbed into the bloodstream from the food that is consumed. By reducing the amount of cholesterol that is absorbed, ezetimibe helps to lower total and LDL cholesterol concentrations in the body. This can be especially beneficial for patients who have high cholesterol levels that are not adequately controlled by other medications, such as atorvastatin.

Explanation

Ezetimibe works by decreasing the absorption of cholesterol in the gastrointestinal tract. This means that less cholesterol is able to be absorbed into the bloodstream from the food that is consumed. By reducing the amount of cholesterol that is absorbed, ezetimibe helps to lower total and LDL cholesterol concentrations in the body. This can be especially beneficial for patients who have high cholesterol levels that are not adequately controlled by other medications, such as atorvastatin.

2. While treating dyslipidemia, after being counseled about lifestyle and dietary changes, the patient was started on atorvastatin. During his treatment with atorvastatin, it is important to routinely monitor serum concentrations of which of the following?

Blood urea

Alanine and aspartate aminotransferase

Platelets

Red blood cells

During treatment with atorvastatin, it is important to routinely monitor serum concentrations of alanine and aspartate aminotransferase. Atorvastatin is a statin medication used to treat dyslipidemia by reducing cholesterol levels. However, statins can cause liver damage, and monitoring liver function tests, such as alanine and aspartate aminotransferase levels, is necessary to detect any potential liver toxicity. Monitoring blood urea, platelets, and red blood cells is not specifically required during atorvastatin treatment.

Explanation

During treatment with atorvastatin, it is important to routinely monitor serum concentrations of alanine and aspartate aminotransferase. Atorvastatin is a statin medication used to treat dyslipidemia by reducing cholesterol levels. However, statins can cause liver damage, and monitoring liver function tests, such as alanine and aspartate aminotransferase levels, is necessary to detect any potential liver toxicity. Monitoring blood urea, platelets, and red blood cells is not specifically required during atorvastatin treatment.

3. Which of the following is a major toxicity associated with gemfibrozil therapy?

Bloating and constipation

Cholelithiasis "gall stones"

Hyperuricemia

Liver damage

Cholelithiasis, or the formation of gallstones, is a major toxicity associated with gemfibrozil therapy. Gemfibrozil is a medication commonly used to lower cholesterol and triglyceride levels in the blood. However, one of its side effects is an increased risk of gallstone formation. Gallstones are solid deposits that form in the gallbladder and can cause symptoms such as abdominal pain, bloating, and indigestion. Therefore, cholelithiasis is a significant concern when considering the use of gemfibrozil as a therapeutic option.

Explanation

Cholelithiasis, or the formation of gallstones, is a major toxicity associated with gemfibrozil therapy. Gemfibrozil is a medication commonly used to lower cholesterol and triglyceride levels in the blood. However, one of its side effects is an increased risk of gallstone formation. Gallstones are solid deposits that form in the gallbladder and can cause symptoms such as abdominal pain, bloating, and indigestion. Therefore, cholelithiasis is a significant concern when considering the use of gemfibrozil as a therapeutic option.

4. In a patient with dyslipidemia and has a history of gout, which of the following drugs is most likely to exacerbate this condition?

Colestipol

Ezetimibe

Gemfibrozil

Niacin

Niacin is most likely to exacerbate gout in a patient with dyslipidemia. Niacin is known to increase uric acid levels in the body, which can lead to gout attacks. Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints. Therefore, prescribing niacin to a patient with a history of gout and dyslipidemia may worsen their gout symptoms.

Explanation

Niacin is most likely to exacerbate gout in a patient with dyslipidemia. Niacin is known to increase uric acid levels in the body, which can lead to gout attacks. Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints. Therefore, prescribing niacin to a patient with a history of gout and dyslipidemia may worsen their gout symptoms.

5. Which of the following is a major mechanism of gemfibrozil's action?

Increased excretion of bile acid salts

Increased expression of high-affinity LDL receptors

Increased secretion of VLDL by the liver

Increased triglyceride hydrolysis by lipoprotein lipase

Gemfibrozil is a medication used to lower triglyceride levels in the blood. It works by increasing the activity of lipoprotein lipase, an enzyme that breaks down triglycerides. This leads to increased triglyceride hydrolysis, resulting in lower levels of triglycerides in the blood. Therefore, the correct answer is "Increased triglyceride hydrolysis by lipoprotein lipase."

Explanation

Gemfibrozil is a medication used to lower triglyceride levels in the blood. It works by increasing the activity of lipoprotein lipase, an enzyme that breaks down triglycerides. This leads to increased triglyceride hydrolysis, resulting in lower levels of triglycerides in the blood. Therefore, the correct answer is "Increased triglyceride hydrolysis by lipoprotein lipase."

6. In patients with combine hyperlipidemia. Which of the following drugs is most likely to increase this patient's triglyceride and VLDL cholesterol concentrations when used as monotherapy?

Atorvastatin

Cholestyramine

Ezetimibe

Gemfibrozil

Cholestyramine is a bile acid sequestrant that works by binding to bile acids in the intestines, preventing their reabsorption and promoting their excretion. This leads to increased clearance of cholesterol from the body, which in turn stimulates the liver to produce more cholesterol. However, cholestyramine can also increase triglyceride and VLDL cholesterol concentrations, particularly in patients with combined hyperlipidemia, which is characterized by elevated levels of both LDL cholesterol and triglycerides. Therefore, when used as monotherapy, cholestyramine is most likely to increase this patient's triglyceride and VLDL cholesterol concentrations.

Explanation

Cholestyramine is a bile acid sequestrant that works by binding to bile acids in the intestines, preventing their reabsorption and promoting their excretion. This leads to increased clearance of cholesterol from the body, which in turn stimulates the liver to produce more cholesterol. However, cholestyramine can also increase triglyceride and VLDL cholesterol concentrations, particularly in patients with combined hyperlipidemia, which is characterized by elevated levels of both LDL cholesterol and triglycerides. Therefore, when used as monotherapy, cholestyramine is most likely to increase this patient's triglyceride and VLDL cholesterol concentrations.