51: Lipid Lowering Therapy

Question 1

What are the two main types of plasma lipid?

Answer 1

Cholesterol and triglycerides

Question 2

How do lipids travel in the body?

Answer 2

Via lipoproteins

Question 3

When do you use lipid lowering therapy in primary prevention? secondary prevention?

Answer 3

Primary - CVS risk > 30% 10 years

Secondary - angina, MI, CVA, PVD, diabetes

Question 4

What is the current target LDL?

Answer 4

< 1.8mmol/L

Question 5

What are the 2 most commonly used statins in NZ?

Answer 5

Atorvastatin and simvastatin

Question 6

What is the mechanism of statins?

Answer 6

Competitively inhibit HMG CoA reductase

Question 7

Where are the pleotropic effects of statins though to come from?

Answer 7

Blockage of isoprenoids

Question 8

What is the most commonly used fibrate in NZ?

Answer 8

Benzafibrate

Question 9

What are the clinical indications for fibrate use?

Answer 9

• Isolated hypertriglycerideaemia

- Combined therapy with statins for resistant hypercholesterolaemia

Question 10

____ is a new agent used in combination therapy with statins

Answer 10

Ezetimibe

Question 11

What is the clinical use of nicotinic acid (B3)?

Answer 11

• Very rarely used in isolation

- Used to reduce triglycerides

Question 12

What do new drugs like evolocumab and inclisiran target?

Answer 12

• PSCK
• Protease that binds to LDL receptors on hepatocyte
• Causes their endocytosis