4.2 Cholesterol and Lipid Lowering Drugs Flashcards
What lifestyle changes are recommended for people with high cholesterol?
No Alcohol Low Sugar, Fat, Cholesterol Diet Exercise Increase Omega 3 Plant Stanols Fibre Vitamin C/E
What is the normal range of Cholesterol?
Total < 5mmol
LDLS < 3mmols
HDLs > 1.2mmols
What do Statins do?
Statins are HMG-CoA Reductase inhibitors
They decrease the levels of LDLs and TGs by preventing production
Increases LDL receptors
What do CAIs do?
Inhibit absorption in the intestines by blocking the channel
Increases LDL receptor expression in the liver
e.g Ezetimibe
Circulates enterohepatically so has a lower systemic exposure
What does Niacin do?
It inhibits the synthesis of lipoprotein a
Best to raise HDL levels
What are Fibrates?
Act on PPAR-alpha
Increases activity of lipoprotein lipase lowers production of TGs
Increases fatty acid uptake/oxidation
Use in hypertrigyceridaemia or with diet changes
Side Effects of Statins
GI symptoms Headaches Arthralgia Myopathy/Rhabdomyolosis Increase Transaminase
DDIs with Statins
CYP Inducers/Inhibitors
OATP2
When should you use Statins?
Primary prevention - familial hypercholesteraemia
Secondary - prevent CV risk
What are Bile Acid Sequestrates
Bind to bile constituents
Prevent reabsorption of Cholesterol in the gut
When should you use CAIs?
When you cannot use statins
In combination - reduces side effects and is 20% more effective
What are the side effects of CAIs?
Headaches
Abdo Pain
Diarrhoea
What are the side effects of CAIs?
Headaches
Abdo Pain
Diarrhoea
What are some benefits of statins
Anti-inflammatory
Reduces Plaques and increases endothelial function
Slows neurodegeration
Prevent prostate cancer
Side effects of Fibrates?
GI upset
LFTs rise
Gallstone risk
Don’t use in renal/liver disease
