Lipid drugs: bile acid sequestrants: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Lipid drugs: bile acid sequestrants

Sample item

A man on cholestyramine for hypercholesterolaemia develops constipation and a rise in triglycerides. Which statement about resins is correct?

AThey lower triglycerides markedlyBThey are well absorbed systemicallyCThey can raise triglycerides and impair absorption of other drugs, which should be taken one hour before or four hours afterDThey cause rhabdomyolysis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. They can raise triglycerides and impair absorption of other drugs, which should be taken one hour before or four hours after

Bile acid sequestrants are not absorbed and bind bile acids in the gut, increasing hepatic LDL receptor expression. They may worsen hypertriglyceridaemia, cause bloating and constipation, and bind drugs such as warfarin, digoxin and thyroxine.

Option by option

A. They lower triglycerides markedly
They tend to raise, not lower, triglycerides.
B. They are well absorbed systemically
They are not absorbed.
C. They can raise triglycerides and impair absorption of other drugs, which should be taken one hour before or four hours after (correct)
Correct. Triglyceride rise and drug binding are recognised effects.
D. They cause rhabdomyolysis
Myopathy is not a feature.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, They can raise triglycerides and impair absorption of other drugs, which should be taken one hour before or four hours after. Bile acid sequestrants are not absorbed and bind bile acids in the gut, increasing hepatic LDL receptor expression.

Why is "They lower triglycerides markedly" not the answer?

They tend to raise, not lower, triglycerides.

Why is "They are well absorbed systemically" not the answer?

They are not absorbed.

Why is "They cause rhabdomyolysis" not the answer?

Myopathy is not a feature.

What concept does this question test?

It tests Lipid drugs: bile acid sequestrants in Pharmacology. They may worsen hypertriglyceridaemia, cause bloating and constipation, and bind drugs such as warfarin, digoxin and thyroxine.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lipid drugs: bile acid sequestrants?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.