27 lipo drugs Flashcards
name the statins
lovastatin(prototype)
simvastatin, pravastatin
atorvastatin, rosuvastatin - more potent
mechanism of statin action
HMG-CoA reductase
rate-limiting step in cholesterol synthesis
also have ‘other’ effects: inflammation reduction, increased endothelial function
statin metabolism
CYP enzymes(all except pravastatin)
adverse effects of statins
hepatitis
rhabdomyolysis(extra protein can hurt kidney)
diabetes induction
teratogenic
polyneuropathy
clinically relavent bile acid binding resins
cholestyramine
cholestyramine mechanism
bind bile acid salts so they cant be reabsorbed
makes the liver utilize more cholesterol to make up for lost salts
adverse effects of cholestyramine
bile-acid binding resin
GI distress
adsorb vitamins/drugs/statins in stomach
can increase TG in hyper-TG
blocks cholesterol absorption
ezetimibe
effective drug for sitosterolemia(hyperabsorption of plant sterols)
ezetimibe
blocks cholesterol/plant sterol absorption
nicotinic acid mechanism
stops lipolysis
decreases ApoA-I catabolism
raises HDL
best hypolipidemic drug for raising HDL
niacin/nicotinic acid
best hypolipidemic drugs for lowering TG
fibrates - gemfibrozil, fenofibrate
best drugs for lowering LDL
statins
simva-statin
prava-statin
atorva-statin
rosuva-statin
familial hypertriglyceridemia effect on lipoproteins
high VLDL
low LPL activity
very high TG levels
familial combined hyperlipidemia effect on lipoproteins
high VLDL
high LDL
high TG
excess apob100