Antihyperlipidemics Flashcards
What suffix do the fibric acid derivatives have?
“Fib”
Includes Gemfibrozil and Fenofibrate
What is the MoA of Fibric Acid Derivatives?
Decrease plasma triglycerides and increase HDL. “This is Reverse Cholesterol transport”
What are Gemfibrozil and Fenofibrate used to treat?
These a fibric acids used to treat hypertriglyceridemia
Familial hypertri
Familial combined Hyperlipoprot
Familial dysbetalop
Secondary Hypertriglycer
What is the major side effect if fibrate derivatives?
Myopathy
Risk is greatly increased with statin use.
What class of drugs are Cholestyramine, colesevelam, colestipol?
These are all bile acid binding resins.
What is the MoA of the drugs Cholestyramine, Colesevelam and colestipol?
These bind bile acids disrupting cholesterol reabsorption.
Treats familial hypercholesterolemia
What suffix do all bile acid binding resins have?
All have the word Col in them!
Makes sense as they lower cholesterol levels.
What side effect of bile acid binding resins should be taken into account?
These drugs lower LDL (cholesterol) but can increase plasma triglycerides.
Thus should not be used in patients with hypertriglyceridemia.
What population of patients are Bile acid binding resins prefered?
Preffered in children and women who are pregnant or lactating.
What effect does Niacin have in the GI?
Decreases VLDL and LDL and increases HDL.
Good for treatment of hypertriglyceridemias and hypercholesterolemias.
What is the function of the drug Ezetimibe?
Ezetimibe is a drug that blocks Niemann Pick C1 like 1 protein.
This prevents dietary cholesterol uptake as well as reuptake of excreted bile.
What health concern is Ezetimibe used to treat?
Used to treat hypercholesteremias.
Which statin is the least potent?
Fluvastatin
Which statin is the most potent?
Atorvastatin and rosuvastatin
How do statins work?
Inhibit HMG-CoA reductase decreasing intracellular cholesterol.
This causes the cell to take up more LDL and secrete less VLDL.
What is the major contraindication for statin use?
What are the side effects in statin use?
Pregnancy is an extreme contraindication.
Can also cause myopathy and liver failure/toxicity.
What are the indications for high intensity statin therapy?
Atherosclerosis
LDL > 190 mg/dL
What are the indications for moderate statin therapy?
40-75 y/o with diabetes and LDL 70-189.
40-75 y/o with 10 year risk of atherosclerotic cv disease and LDL 70-189.
What is typically the first line agent for hypercholesteremia?
Statins
If statins dont work for hypercholesterolemia, what should be used instead?
Cholesterol absorption inhibitors or bile acid binding resins.
Niacin can always be used as well.
What are the two drug type of choice for hypertriglyceridemia?
Fibrates and niacin.
Elevated VLDL
