Anti-Lipids
Inhibits bile acid reuptake in the intestine so the liver must rely on cholesterol for new bile syntehsis. Treats high LDL
Cholestyramine
Treats all nematodes, liver flukes (clonorchis sinensis) and estode (Echinnococus). Inhibits microtubules assembly and ferroreductase
Albendazole
A patient presents with shortness of breath, fever, decreased bowel sounds, and constipation/notably decreased flatulence. PMH significant for recent travel to Mexico for a gardening retreat two months ago
Treat with Albendazole. The patient most likely has Ascaris lumbricoides causing SBO and pneumonitis
Cholestryamine
These drugs can treat liver flukes
Albendazole and Praziquantel
Activates PPAR-a which incudes/upregulates lipoprotein lipase causes increased TG clearance and upregulation of HDL synthesis
What is Gemfibrozil (Fibrates)
Cestodes (tapeworm) and trematodes (schisto and liver fluke) s/p glucocorticoid treatment. Increases membrane permeability to calcium
Praziquantel
A 5 yo boy presents with insomnia and perianal itching. You perform a scotch tape test that is positive. Of note, his parents have a very high deductible insurance plan to keep their monthly payments low and are tight on money.
Treat with Pyrantel Pamoate which is OTC, much cheaper than Albendazaole
Simvastatin
This medication potentiates warfarin
Gemofibrozil
Inhibits HMG-CoA reductase so HMG-CoA is NOT converted to mevalonate which is a cholesterol precursor. It decreases mortality in CAD
Simvastatin (Zocor)
Roundworm (Strongyloides) filarial infections, roundworms (onchocerca and elephantitis), head lice. Activates intervertabrate chloride channels
Ivermectin
A patient comes in for follow-up after his annual labs. Labs were significant for elevated triglycerides and elevated LDL. He tried a statin two months ago and failed treatment.
Treat with Niacin
Flushing, aminotransferase elevation, hyperuricemia can exacerbate gout, hyperglycemia
Niacin
Causes acidification due to lactic acid in gut lumen which allows for conversion of NH3 to NH4+(ammonium0, making it unabsorable
Lactulose
Inhibits cholesterol absorption via HPCL11, a transmembrane protein on the apical membrane of sm intestine enterocyte brush border
Ezetimibe
Enterobius vermicularis. Depolarizing neuromuscular blocking agent causing contracting and paralysis of helminth (pinworm) so it is passed in feces
Pyrantel pamoate
A newborn presents with fatigue, irritability, inability to track an object with eyes, easy bruising, and is difficult to arouse. Labs significant for elevated ammonia.
Lactulose preferred over Rifaximin because Rifaximin can inferfere with Vitamin K
Can cause cholelithiasis and increased risk of rhabdo if taking in combination with a HMG-CoA reductase inhibitor
Gemofibrozil
Used in hepatic encepalopathy, is a poorly absorbed antibiotic that decreases colonic deamination by urea metabolism. Increases risk of C. Diff, can interfere with vitamin K, and cause diarrhea
Rifaximin
Monoclonal ab binds to PCSk9 which causes an increase in LDL-receptor expression and greater LDL clearance. Reduces all-cause cardiovascular mortality
PCSK9 inhibitor
Albendazole (nausea and abd pain)
Pyrantel pamoate (diarrhea and abd pain)
Praziquantel (dizziness and abd pain)
A patient with mild obesity presents with elevated LDL. They want the medication with the least amount of side effects. The last medication they tried left them feeling sore all the time.
Ezetimbe
Name drugs for High intensite, Moderate intensit, and low intensity risk of ASCVD
Moderate: Simvastatin 20-40mg and Atorvastatin 10-20 mg
Low: Simvastatin 10 mg
Patient with PMH of HIV presents with diarrhea, abdominal pain, fever, and hypotension. Eosinophilia is noted on microscopy.