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Pharma S1Y2 > anti dyslipid > Flashcards

anti dyslipid Flashcards

1
Q

hats the goal of anti dyslipidemia therapy?

A

lower LDL and VLDL and increase HDL

not all the available drugs are effective in all lipoprotein

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2
Q

what are the hypolipidemic agents?

A

1- statins
2- bile acid sequestrants
3- fibrates
4-nicotinic acid
5-plant sterols
6- agents reducing cholesterol absorption from intestine ( ezetimibe )

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3
Q

what are the most effective and most widely prescribed and best tolerated group?

A

statins

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4
Q

what are the bile acid sequestrants? or RESINS

A

cholestyramine and colestipol

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5
Q

whats their mechanism of action?

A

bind to bile acid and stops cholesterol and triglyceride absorption

will it make bile get secreted outside so the liver has to make new bile–> and bile is made via cholesterol and then the new bile come and same thing again it gets excreted and again

cholesterol is decreased and wasted in bile and is excerted

work mainly on cholesterol

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6
Q

what are the adverse effects of cholestyramine?

A
  • Constipation ( heart burn, abdominal pain , bloating, nausea )
  • Impaired absorption of any fat soluble compound : vitamines and anticoagulat , digoxin, thyroid
  • bind weak acidic drugs
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7
Q

what are the inhibitors of intestinal sterol absorption?

A

ezetimibe

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8
Q

whats the mechanism of action of ezetimibe ?

A

binds directily to the cholesterol and impair its absorption

work only on cholesterol

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9
Q

what drugs do you usually combine ezetimibe with to reduce cholesterol?

A

statins

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10
Q

what are common adverse effects of ezetimibe?

A

fatigue , abdominal pain, diarrhea

reversible hepatic dysfunction

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11
Q

what are statins?

A

HMG coa- reductase inhibitor?

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12
Q

whats the mechanism of action of statins?

A

inhibit HMG COA- reductase and INHIBIT CHOLESTEROL SYNTHESIS IN THE LIVER.

Increased LDL receptors ( decreasing ldl in circulation)

WORK MAINLY ON CHOLESTEROL

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13
Q

what are the uses of statins?

A

familial and non familial hypercholesterolmias

reduce osteoporosis

reduce incidence of some cancers

imrpove endothelial function

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14
Q

what are the adverse effects of statins?

A

H –> hepatic dysfunction and elevation of transaminases

M–> myopathies, myositis,rhabdomyolysis , myoglobinuria and increased creatine kinase in blood due to heart muscle damage

G–> GIT upset –> nausea , epigastirc fullnes, vomitting

COA –? cataract ( lenticular opacity )

REDUCTASE –> renal dysfunction ( could lead to hypotension )

other side notes,
given in night

contraindicated in pregnancy
dont give with drugs that inhibit cyp450

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15
Q

whats drugs could lead to increased statin levels?

A

eryhtromycin
cyclosporin
gemfibrozil
niacin

cuz these drugs inhibit cyp450?

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16
Q

what are the fibrates agents?

A

colfibrate, fenofibrate,bezafibrate anything that ends with fibrate

17
Q

whats the mechanism of action of fibrates?

A

they increase the activity of lipoprotein lipase ( which apo protein activate lipoprotein lipase)

SO mainly works on triglycerides not cholesterol

18
Q

what are the uses of fenofibrate?

A
  • used treat hyperlipidemia of several causes

has some uricosuric effect ( decreases uric acid )

19
Q

when is fenofibrate is useleess?

A

in primary chylomicronemia where theres a deficiency in lipoprotein lipase

why cuz the enzyme itself its not there so theres nothing to work

20
Q

what are the side effects of fenofibrates?

A

-cholelithiasis and cholecystitis

  • GI upsets –> nausea and vomiting like statins and bile sequetrates
  • Hepatic dysfunction ( elevate enzyme levels ) like statins
  • myopathies like statins
21
Q

what are nicotinic acids?

A

vitamin b3 ( NIACIN )

22
Q

whats the mechanism of action of niacin?

A

Reduce VLDL production in liver by inhibiting lipolysis of adipose tissue ( inhibit adipose tissue lipase enzyme )

work on both cholesterol and triglycerides

23
Q

what are other uses of niacin?

A

in low doses can be used as vitamin supplement in treatment of pellagra

24
Q

which type of vitamin is niacin

A

its vitamin B so water soluble

25
Q

what are the side effects of niacin?

A

Skin flushing and tingling and headache cuz it increases PGI and histamine ( countered by aspirin )

  • GI irration, nausea and vomitting
  • Peptic ulcer

-Hyperglycemia ( contraindicated in diabetic patients )

  • Hyperuricemia ( contraindicated in gout )

-hepatotoxicity

26
Q

whats the function of Evolocumab , alirocumab

A

they are PCSK9 inhibitors

27
Q

whats the function of PCSK9?

A

downregulate the LDL receptors

28
Q

statins work mainly on reducing what?

A

Cholesterol and LDL ( decrease by 20-50)

29
Q

fibrates work mainly on reducing what?

A

triglycerides ( decrease by 20-50 )

30
Q

niacin works mainly reducing what?

A

triglycerides (20-50%)

increase HDL ( 15-35%)

Pharma S1Y2 (10 decks)

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