Therapeutic Lifestyle & Pharmacologic Interventions Flashcards

Ezetimibe works by inhibiting which intestinal transporter responsible for cholesterol absorption?

Answer: NPC1L1 (Niemann-Pick C1-Like 1)

Ezetimibe selectively inhibits the NPC1L1 transporter at the brush border of small intestinal enterocytes, reducing dietary and biliary cholesterol absorption.

In a patient with familial chylomicronemia syndrome (FCS) due to lipoprotein lipase deficiency, which drug is specifically approved for this indication?

Answer: Volanesorsen

Volanesorsen is an antisense oligonucleotide targeting apoC-III, approved for familial chylomicronemia syndrome to reduce severely elevated triglycerides.

Which dietary intervention has the strongest evidence for raising HDL-C levels?

Answer: Regular moderate-to-vigorous aerobic exercise

Regular aerobic exercise is the most evidence-based lifestyle intervention for raising HDL-C, with increases of 3-9% typically observed.

A CLS is counseling a patient about statin-associated muscle symptoms (SAMS). Which statin-related factor increases the risk of myopathy?

Answer: High-dose statin therapy

Higher statin doses are associated with significantly greater risk of SAMS and rhabdomyolysis due to elevated drug exposure.

Evolocumab (Repatha) and alirocumab (Praluent) reduce LDL-C primarily by which mechanism?

Answer: Preventing PCSK9-mediated degradation of LDL receptors

PCSK9 inhibitor monoclonal antibodies bind to PCSK9 protein, preventing it from binding to and degrading LDL receptors, thereby increasing LDL receptor recycling and LDL uptake.

Which patient population is most likely to benefit from fenofibrate therapy as evidenced by subgroup analyses from clinical trials?

Answer: Patients with combined dyslipidemia (high TG + low HDL)

Subgroup analyses from ACCORD and other trials suggest fenofibrate may benefit patients with combined dyslipidemia (TG ≥200 and HDL ≤34 mg/dL).

Soluble fiber (e.g., psyllium, oat bran, pectin) lowers LDL-C through which primary mechanism?

Answer: Increasing bile acid excretion by forming gel in the intestine

Soluble fiber forms a viscous gel in the intestine that binds bile acids and increases their fecal excretion, forcing the liver to use cholesterol to synthesize new bile acids.