4.2 Cholesterol Control Flashcards
Why is it important to have a normal range of cholesterol?
High cholesterol can lead to atheromatous disease which can have CVS consequences
What is the ideal total cholesterol levels?
<5.0 mmol/L
Describe the mechanism of atherosclerosis formation
Endothelial dysfunction leads to infiltration of LDLs in the arterial wall. The LDLs are oxidised causing inflammation and platelet aggregation. Over time, this leads to a fibrous cap forming over a lipid core.
What is the general mechanism of a statin?
Inhibit the hepatic enzyme HGM-CoA reductase to stop cholesterol synthesis
As cholesterol is lowered, the LDL receptors are up-regulated so serum LDL levels are reduced
Give an example of a short acting statin
Simvastatin
Give 2 examples of a long-acting statins
Atorvastatin
Rosuvastatin
Give 4 common side effects of statins
Myopathy Rhabdomyolysis Raised transaminase levels Headaches GI disturbances
What test should be done to monitor patients on statins?
LFTs to check for liver damage
What receptor do fibrates act on?
PPAR-alpha receptor
What effects do fibrates have on levels of cholesterol, LDLs, HDLs and TAGs?
Lowered cholesterol
Reduced LDLs
Largely lowers TAGs
Raises HDLs
Give 3 ADRs of fibrates
GI upset
Muscle ache
Increased gallstone risk
How does Niacin act to reduce cholesterol?
Inhibits lipoprotein a synthesis so reduces VLDLs and increases HDLs
Give 3 ADRs of Niacin
Flushing Itching Headache Hepatotoxicity Peptic ulcers Hyperglycaemia
How does Ezetimibe work?
Selectively inhibits intestinal cholesterol absorption
Give 2 ADRs of Ezetimibe
Headaches
Abdominal pain
Diarrhoea
