Therapeutic Lifestyle & Pharmacologic Interventions Flashcards

Colesevelam (Welchol) has which unique advantage over older bile acid sequestrants like cholestyramine?

Answer: Improved glycemic control in type 2 diabetes

Colesevelam is FDA-approved as an adjunct to improve glycemic control in type 2 diabetes in addition to its LDL-C–lowering effect.

The REDUCE-IT trial demonstrated that icosapentaenoic acid (EPA, 4g/day) reduced cardiovascular events by approximately what percentage in statin-treated patients with elevated triglycerides?

Answer: 25%

REDUCE-IT showed icosapentaenoic acid (Vascepa) reduced major adverse cardiovascular events by approximately 25% relative to placebo in high-risk statin-treated patients.

Which lipoprotein measurement is most directly reduced by niacin therapy, making it useful in patients with isolated low HDL-C?

Answer: HDL-C

Niacin produces the largest increase in HDL-C of any available lipid-modifying drug, typically raising it by 15-35%.

A patient on gemfibrozil asks about starting rosuvastatin for elevated LDL-C. What is the primary concern with this combination?

Answer: Significantly increased risk of myopathy and rhabdomyolysis

Gemfibrozil inhibits statin glucuronidation, dramatically increasing statin plasma levels and the risk of myopathy; fenofibrate is the preferred fibrate when combined with statins.

Plant stanols and sterols reduce LDL-C through which primary mechanism?

Answer: Competing with dietary cholesterol for intestinal absorption

Plant stanols and sterols structurally compete with cholesterol for micellar incorporation, reducing intestinal cholesterol absorption by ~30-40%.

Bempedoic acid lowers LDL-C by inhibiting which enzyme in the cholesterol synthesis pathway?

Answer: ATP citrate lyase (ACL)

Bempedoic acid inhibits ATP citrate lyase (ACL), an enzyme upstream of HMG-CoA reductase, reducing hepatic cholesterol synthesis.

Which physical activity recommendation best aligns with TLC guidelines for cardiovascular risk reduction in lipid management?

Answer: At least 30 minutes of moderate-intensity exercise most days of the week

TLC guidelines recommend at least 30 minutes of moderate-intensity physical activity on most, preferably all, days of the week.