Pharm Antihyperlipidemics

20 Questions | By Chachelly | Last updated: May 6, 2019

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In today’s quiz on drugs associated with particular medical conditions, we’ll be looking at antihyperlipidemic agents, which are used in the treatment of high levels of fats and cholesterol in the blood. What can you tell us about these drugs and what their specific uses are?

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Questions and Answers

1.

Directions: questions 1-4 Match each antihyperlipidemic drug with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug can sometimes cause hypertriglyceridemia
- A.
  
  Cholestyramine
- B.
  
  Ezetimibe
- C.
  
  Gemfibrozil
- D.
  
  Niacin
- E.
  
  Lovastatin
2.

Directions: questions 1-4 Match each antihyperlipidemic drug with the appropriate description (each lettered option can be selected once, more than once, or not at all): Facial flushing is the most common adverse effect of this drug
- A.
  
  Cholestyramine
- B.
  
  Ezetimibe
- C.
  
  Gemfibrozil
- D.
  
  Niacin
- E.
  
  Lovastatin
3.

Directions: questions 1-4 Match each antihyperlipidemic drug with the appropriate description (each lettered option can be selected once, more than once, or not at all): High doses of this drug can cause metabolic acidosis
- A.
  
  Cholestyramine
- B.
  
  Ezetimibe
- C.
  
  Gemfibrozil
- D.
  
  Niacin
- E.
  
  Lovastatin
4.

Directions: questions 1-4 Match each antihyperlipidemic drug with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug activates a nuclear transcription receptor
- A.
  
  Cholestyramine
- B.
  
  Ezetimibe
- C.
  
  Gemfibrozil
- D.
  
  Niacin
- E.
  
  Lovastatin
5.

A 21-year-old woman recently diagnosed with familial combined hyperlipidemia, started a treatment with lovastatin. Which of the following molecular actions most likely mediated the therapeutic efficacy of the drug in the patient’s disease?

Discuss
- A.
  
  Down-regulation of hepatic LDL receptors
- B.
  
  Increased synthesis of lipoprotein lipase
- C.
  
  Decreased synthesis of mevalonic acid
- D.
  
  Decreased storage of LDL in hepatic endosomes
- E.
  
  Increased plasma levels of hepatic aminotransferases
- F.
  
  Increased plasma levels of creatine phosphokinase
6.

A 28-year-old woman, recently diagnosed with familial combined hyperlipidemia, started a treatment with a low fat diet and cholestyramine. The therapy most likely caused the highest reduction of plasma levels of which of the following compounds?

Discuss
- A.
  
  VLDL
- B.
  
  HDL
- C.
  
  LDL
- D.
  
  Chylomicrons
- E.
  
  Triglycerides
7.

A 54-year-old obese man had a plasma LDL cholesterol of 270 mg/dL in spite of 4 month therapy with lovastatin. The physician decided to add cholestyramine to the patient’s regimen. Recently the patient was found to have a stage I hypertension and he was currently taking propranolol and hydrochlorothiazide. Which of the following changes in the pharmacokinetics of these two drugs most likely occurred because of cholestyramine administration?

Discuss
- A.
  
  Renal elimination of propranolol increased
- B.
  
  Renal elimination of hydrochlorothiazide decreased
- C.
  
  Oral bioavailability of propranolol increased
- D.
  
  Oral bioavailability of hydrochlorothiazide decreased
- E.
  
  Volume of distribution of propranolol increased
- F.
  
  Volume of distribution of hydrochlorothiazide decreased
8.

A 52-year-old man was found to have a total cholesterol of 380 mg/dL and triglycerides of 230 mg/dL in spite of three months of low saturated fat diet. The man had been suffering from hemophilia since birth and from external hemorrhoids for two years. An antihyperlipidemic therapy was prescribed. Which of the following drugs would be contraindicated in this patient?

Discuss
- A.
  
  Lovastatin
- B.
  
  Cholestyramine
- C.
  
  Ezetimibe
- D.
  
  Niacin
- E.
  
  Gemfibrozil
9.

A 24-year-old woman suffering from familial hypertriglyceridemia was screened with a blood profile during a follow-up visit. Relevant laboratory test results were: uric acid 15 mg/dL (normal 4-8.5), total cholesterol 170 mg/dL (normal < 200), triglycerides 1230 mg/dL (normal < 200). A lipid-lowering drug was prescribed. Which of the following was most likely the mechanism of action of that drug?

Discuss
- A.
  
  Decrease of lipid synthesis on adipose tissue
- B.
  
  Down-regulation of LDL receptors in the liver
- C.
  
  Inhibition HMG-CoA reductase activity in the liver
- D.
  
  Stimulation of lipoprotein lipase synthesis
- E.
  
  Decreased absorption of exogenous cholesterol
10.

A 55-year-old obese woman was found to have a cholesterol level of 360 mg/dL despite many months of lovastatin treatment. The physician decided to add ezetimibe to the therapeutic regimen. Which of the following cells represents the main site of action of the added drug?
- A.
  
  Adipocytes
- B.
  
  Capillary endothelial cells
- C.
  
  Platelets
- D.
  
  Hepatocytes
- E.
  
  Intestinal epithelial cells
11.

A 57-year-old man was found to have a LDL-cholesterol of 360 mg/dL in spite of 5 months of treatment with lovastatin. The physician decided to add ezetimibe to the therapeutic regimen. Which of the following statements best explain the rationale of adding this drug to lovastatin therapy?

Discuss
- A.
  
  The combination decreases the risk of lovastatin-induced myopathy
- B.
  
  The combination results in synergistic cholesterol-lowering effects
- C.
  
  Ezetimibe slows down the metabolism of lovastatin
- D.
  
  Ezetimibe increases the intestinal absorption of lovastatin
- E.
  
  The combination strongly increases HDL plasma levels
12.

A 46-year-old man, suffering from familial hypercholesterolemia, was found to have a total cholesterol of 430 mg/dL in spite of many months of treatment with lovastatin. Triglyceride levels were normal. The physician decided to add niacin to the therapeutic regimen. Which of the following molecular action most likely mediated the therapeutic efficacy of the drug in the patient’s disease?

Discuss
- A.
  
  Inhibition of VLDL production by the hepatocyte
- B.
  
  Inhibition of HDL synthesis by the liver
- C.
  
  Increase of circulating fibrinogen
- D.
  
  Stimulation of lipolysis in adipose tissue
- E.
  
  Decreased absorption of exogenous cholesterol
13.

A 47-year-old man was brought by ambulance to the coronary unit with the admitting diagnosis of myocardial infarction. An emergency therapy was started which included alteplase, aspirin, heparin, and metoprolol. The next day lovastatin and ezetimibe were added to the therapeutic regimen. Which of the drugs received by the patient acts mainly on liver cell cytosol?

Discuss
- A.
  
  Alteplase
- B.
  
  Aspirin
- C.
  
  Lovastatin
- D.
  
  Heparin
- E.
  
  Ezetimibe
- F.
  
  Metoprolol
14.

A 52-year-old obese man suffering from gout and hypertension was found to have LDL cholesterol of 360 mg/dL and a serum uric acid of 15.5 mg/dL during a follow-up visit. Other laboratory values were within normal limits. A lipid-lowering therapy is prescribed. Which of the following antihyperlipidemic drugs would be relatively contraindicated in this patient?
- A.
  
  Cholestyramine
- B.
  
  Niacin
- C.
  
  Ezetimibe
- D.
  
  Lovastatin
- E.
  
  Gemfibrozil
15.

A 56-year-old woman, suffering from familial hypercholesterolemia, was found to have a total cholesterol of 470 mg/dL in spite of many months of treatment with lovastatin. Triglyceride levels were normal. The physician decided to add niacin to the therapeutic regimen. Which of the following drugs should be given during the first days of therapy, to avoid niacin induced hot flushes?

Discuss
- A.
  
  Warfarin
- B.
  
  Atropine
- C.
  
  Aspirin
- D.
  
  Prazosin
- E.
  
  Gemfibrozil
16.

A 45-year-old obese man suffering from type I diabetes mellitus and hyperlipidemia was admitted to the hospital because of vomiting and circulatory collapse. The patient had started an antihyperlipidemic therapy one month ago. Pertinent plasma data on admission were: pH 7.32, HCO3 12 mEq/L (normal 22-26), PaCO2 16 mm Hg (normal 25- 45), Cl 125 mEq/L (normal 90-105). Which of the following drugs could have contributed to the syndrome the patient was suffering from?

Discuss
- A.
  
  Lovastatin
- B.
  
  Insulin
- C.
  
  Niacin
- D.
  
  Gemfibrozil
- E.
  
  Cholestyramine
17.

A 57-year-old woman was found to have triglyceride levels of 630 mg/dL during a follow-up visit.. A therapy with gemfibrozil was prescribed. Which of the following cellular structures most likely represents the site of action of this drug?
- A.
  
  Smooth endoplasmic reticulum
- B.
  
  Nucleus
- C.
  
  Cell membrane
- D.
  
  Cytoplasm
- E.
  
  Rough endoplasmic reticulum
- F.
  
  Mitochondria
18.

A 45-year-old man complained to his physician of muscle aches, soreness and weakness. The patient had been suffering from duodenal ulcer for 2 years, from familial hypercholesterolemia for 5 years and from open angle glaucoma for one year. Present therapy included famotidine and sucralfate for ulcer, lovastatin for hyperlipidemia and timolol and latanoprost for glaucoma. An urinalysis showed myoglobinuria. Which of the following drugs most likely caused this finding?

Discuss
- A.
  
  Latanoprost
- B.
  
  Famotidine
- C.
  
  Timolol
- D.
  
  Sucralfate
- E.
  
  Lovastatin
19.

A 49-year-old man was found to have the following lipid profile during a routine visit: LDL cholesterol 180 mg/dL (normal < 200), HDL cholesterol 14 mg/dL (normal > 35), triglycerides 150 mg/dL (normal < 200). The man weighted 134 Kg and was a heavy cigarette-smoker. Which of the following antihyperlipidemic drugs would be most appropriate for this patient?

Discuss
- A.
  
  Gemfibrozil
- B.
  
  Lovastatin
- C.
  
  Cholestyramine
- D.
  
  Niacin
- E.
  
  Ezetimibe
20.

A 26-year-old obese woman, who was found to have a LDL-cholesterol level of 270 mg/mL despite four months of diet, started a lipid-lowering therapy with cholestyramine. Which of the following is the main site of action of action of this drug?
- A.
  
  Liver
- B.
  
  Small intestine
- C.
  
  Colon
- D.
  
  Plasma
- E.
  
  Adipose tissue
- F.
  
  Gall bladder

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