Statins Central
Which enzyme is inhibited by statins?
a. NPC1L1
b. HMG-CoA reductase
c. LPL
d. ACAT
B. HMG-CoA reductase
Which drug class is most effective in lowering triglycerides?
a. Statins
b. PCK9 Inhibitors
c. Resins
d. Fibrates
D. Fibrates
Which drug blocks intestinal cholesterol absorption?
a. Niacin
b. Fenofibrate
c. Ezetimibe
d. Colestipol
C. Ezetimibe
Which drug is administered subcutaneously?
a. Rosuvastatin
b. Niacin
c. Cholestyramine
d. Evolocumab
D. Evolocumab
Which drug is contraindicated in pregnancy?
a. Statins
b. Ezetimibe
c. Resins
d. Omega-3
A. Statins
Which statin has the longest half-life and may be given anytime?
a. Simvastatin
b. Lovastatin
c. Atorvastatin
d. Fluvastatin
C. Atorvastatin
Which drug increases HDL the most?
a. Niacin
b. Atorvastatin
c. Fenofibrate
d. Ezetimibe
A. Niacin
Which drug is NOT systemically absorbed?
a. Atorvastatin
b. Cholestyramine
c. Niacin
d. Gemfibrozil
B. Cholestyramine
PCSK9 inhibitors work mainly by which mechanism?
a. Increasing LDL receptor recycling
b. Blocking cholesterol absorption
c. Decreasing TG synthesis
d. Activating PPAR-α
A. Increasing LDL receptor recycling
Which drug commonly causes flushing?
a. Niacin
b. Fenofibrate
c. Rosuvastatin
d. Colesevelam
A. Niacin
Modified True or False
Statins reduce LDL by decreasing LDL receptor activity.
False
Statins increase LDL receptor expression.
Modified True or False
Gemfibrozil is safer than fenofibrate when combined with statins.
False
Fenofibrate is safer.
Modified True or False
Bile acid resins decrease triglyceride levels.
False
Bile acid resins may increase triglycerides.
Modified True or False
PCSK9 inhibitors are first-line therapy for all dyslipidemia patients.
False
PCSK9 inhibitors are reserved for high-risk or statin-resistant patients.
Modified True or False
Statins can be safely combined with strong CYP3A4 inhibitors.
False
Risk of toxicity increases.
What is the most common serious muscle-related adverse effect of statins?
Myopathy / Rhabdomyolysis
What is the nuclear receptor activated by fibrates?
PPAR-α /
Peroxisome proliferator-activated receptors
What is the intestinal transporter blocked by ezetimibe?
NPC1L1
Identify TWO PCSK9 inhibitors.
Alirocumab, Evolocumab
Identify the drug that binds warfarin and digoxin in the gut.
Bile acid resins (Cholestyramine/Colestipol)
Enumerate THREE pleiotropic effects of statins.
Anti-inflammatory
Plaque stabilization
Improved endothelial function
Reduced platelet aggregation
Decreased oxidative stress
Enumerate THREE (3) contraindications of niacin.
Answer (Any 3):
Gout
Diabetes mellitus
Pregnancy
Peptic ulcer disease
Liver disease
Enumerate THREE (3) adverse effects of bile acid resins.
Answer (Any 3):
Constipation
Bloating
Flatulence
Vitamin deficiency
Abdominal discomfort
Enumerate THREE (3) indications for PCSK9 inhibitors.
Answer (Any 3):
Familial hypercholesterolemia
Statin intolerance
Refractory high LDL
ASCVD with uncontrolled LDL
Enumerate THREE (3) baseline tests before starting statins.
Answer (Any 3):
ALT/AST
Lipid profile
CK (if high-risk)
Renal function
Fasting glucose