CLS Non-Statin Lipid-Lowering Pharmacotherapy

Question 1

What is the primary mechanism of action of ezetimibe?

Accepted Answer

Blocks cholesterol absorption at the Niemann-Pick C1-Like 1 (NPC1L1) transporter in the small intestine

Answer

Inhibits HMG-CoA reductase in the liver

Answer

Binds bile acids in the intestinal lumen to prevent reabsorption

Answer

Activates peroxisome proliferator-activated receptor alpha (PPARα)

Question 2

Which bile acid sequestrant is FDA-approved for both hypercholesterolemia and as an adjunct treatment for type 2 diabetes?

Accepted Answer

Colesevelam

Answer

Cholestyramine

Answer

Colestipol

Answer

Colestimide

Question 3

What is the expected LDL-C reduction with ezetimibe monotherapy?

Accepted Answer

15–25%

Answer

5–10%

Answer

30–40%

Answer

45–55%

Question 4

Bile acid sequestrants are contraindicated in patients with triglyceride levels exceeding which threshold?

Accepted Answer

400 mg/dL

Answer

150 mg/dL

Answer

200 mg/dL

Answer

1000 mg/dL

Question 5

The IMPROVE-IT trial studied ezetimibe added to simvastatin in patients with recent acute coronary syndrome. What was the primary finding?

Accepted Answer

A significant reduction in major adverse cardiovascular events

Answer

No significant reduction in major adverse cardiovascular events

Answer

A reduction in all-cause mortality only

Answer

An increase in hemorrhagic stroke risk

Question 6

What is the most clinically significant drug interaction concern with bile acid sequestrants?

Accepted Answer

They bind and reduce intestinal absorption of many co-administered medications

Answer

They increase systemic absorption of warfarin

Answer

They increase myopathy risk when combined with statins

Answer

They increase bioavailability of thyroid hormones

Question 7

Which of the following is NOT classified as a bile acid sequestrant?

Accepted Answer

Ezetimibe

Answer

Cholestyramine

Answer

Colestipol

Answer

Colesevelam