1 - Cholesterol Flashcards
What are the guidelines for LDL cholesterol?
- *70 - ideal
- < 100 - optimal
- 100-129 - near optimal
- 130-159 - borderline high
- 160-189 - high
- >190 very high
What are the guidelines for total cholesterol?
- <200 - desirable
- 200-239 - boderline high
- >240 high
What are the guidelines for HDL cholesterol?
- < 40 - low
- > 60 - high
What are the guidelines for triglycerides?
- <150 - normal
- 150-199 - boderline high
- 200-499 - high
- >500 - very high
Why is Lipitor the #1 drug in terms of sales worldwide for the 6th year in a row?
New lower target of “70” for optimal LDL range is virtually impossible to reach without “statins”
What is a class of medications used to reduce cholesterol by binding bile acids in the gut?
Bile Acid Sequesters
What are some common preparations of Bile Acid Sequesters?
“cole-“ or “chole”
- cholestyramine resin
- colesevelan
- colestipol
What drug decreases liver triacylglycerol synthesis necessary for VLDL production?
Nicotinic Acid (Niacin)
What’s the common side effect of niacin?
Facial flushing
What do fibric acids do?
- Lowers plasma triglycerides
- Increases HDLs
- Inhibits cholesterol synthesis in liver
What are the common preparations of fibric acids?
Look for “fiber” sound in name!
- clofibrate (Atromid)
- fenofibrate (Tricor)
- gemfibrozil (Lopid)
What is the rate-limiting step in the synthesis of cholesterol?
HMG-CoA reductase
What type of drugs are the “statins”?
HMG CoA Reductase Inhibitors
There’s new evidence that shows that HMG CoA reductase inhibitors may have _____________ activity?
Anti-inflammatory
HMG CoA Reductase Inhibitors cannot be taken if patient has what?
Liver disease - drugs may alter liver function
What are some side effects of HMG CoA reductase inhibitors?
- myalgias
- rhabdomyolysis - disintegration of the muscle tissue
What are the important dental drug interactions with HMG CoA reductase inhibitors?
Avoid use of:
- Macrolide antibiotics (erythromycin)
- Systemic (azole) antifungals
They will promote rhabdomyolysis
What is Vytorin?
Combination of a statin drug (Zocor) with ezetimibe (Zetia)
**Vytorin = Zetia + Zocor **
Long term studies shows no greater benefit of using this combo compared to statin alone
What are the oral considerations with lipid lowering agents?
- Multiple drug interactions
- Assess risk for increased bleeding
- Avoid azole antifungals, macrolide antibiotics with HMG CoA reductase inhibitors
- Assess changes in cholesterol lowering meds at each visit
