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104. (e) Questran (Cholestyramine) is classified as a the body’s cholesterol level. The recommended
bile-acid binding resin. It is indicated for the dose of Colestipol is 2 to 16 grams as a single or in
reduction of an elevated serum cholesterol levels in two divided doses.
patients with hypercholesterolemia.
Flatulence, constipation, abdominal pain, nausea,
The recommended dose of Questran is 8 to 16 vomiting, dyspepsia and heartburn are reported
grams per day in two divided doses. It should be side effects of Colestipol. The drug should be taken
taken with plenty of water to prevent constipation. with plenty of water to prevent constipation.

Flatulence, constipation, abdominal pain, nausea, 107. (e) Zocor (Simvastatin), Mevacor, Altocor,
vomiting, dyspepsia and heartburn are reported Altoprev (Lovastatin), Livalo (Pitavastatin), Crestor
side effects of the drug. (Rosuvastatin), Lescol, Lescol XL (Fluvastatin),
Lipitor (Atorvastatin) and Pravachol (Pravastatin)
It should be avoided with drugs that contain the are HMG-COA reductase inhibitors. An inhibition of
carboxylic acid group in their chemical structures. It HMG-COA reductase enzyme prevents the
binds to the acidic moiety of these drugs and conversion of HMG-COA to a mevalonate, which is
reduces the absorption and bioavailability of these an early step in the synthesis of cholesterol.
drugs.
It is recommended that liver function tests should
105. (a,b). Dose adjustments may be necessary in be performed before and two to three months after
patients with concomitant use of: initiating therapy with statins.

Strong CYP1A2 inhibitors (e.g., fluvoxamine, Name Dose Time Food
ciprofloxacin, or enoxacin);
Pitavastatin Any Time With or without
Moderate or weak CYP1A2 inhibitors (e.g., oral Simvastatin Evening N/A
contraceptives, or caffeine); Atorvastatin Any Time With or without
Fluvastatin Evening With or without
CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, Pravastatin Any Time With or without
escitalopram, erythromycin, paroxetine, bupropion, Lovastatin Evening With food
fluoxetine, quinidine, duloxetine, terbinafine, or Rosuvastatin Any Time With or without
sertraline);
108. (c) Minipress (Prazosin) is classified as a
CYP3A4 inducers (e.g., phenytoin, carbamazepine, specific alpha-1 blocker. It is indicated for the
St. John’s wort, and rifampin); or treatment of hypertension. The recommended dose
is 1 mg two to three times a day.
CYP1A2 inducers (e.g., tobacco smoking).
Maintenance dose: Dosage may be slowly
106. (c) Colestid (Colestipol) is classified as a bile increased to a total daily dose of 20 mg given in
acid binding resin. It can be substituted for divided doses. The therapeutic dosages most
Questran (Cholestyramine). Both these drugs bind commonly employed have ranged from 6 mg to 15
to bile acid in the intestine and prevent its mg daily given in divided doses. Doses higher than
reabsorption. They form an insoluble complex with 20 mg usually do not increase efficacy, however a
bile acid which is then excreted in the feces. The few patients may benefit from further increases up
loss of bile acid stimulates the hepatic synthesis of to a daily dose of 40 mg given in divided doses.
bile acid from cholesterol, and may help reducing

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