Antihyperlipidemics Flashcards
Statins
inhibit HMG coA reductase
decrease endogenous liver cholesterol —> increasing LDL receptors on the liver and the uptake of LDL from the blood
When are statins given?
hypercholesterolemia acute MI HTN diabetics previous TIA
What are the side effects of statins
teratogenic myopathy increaed LFTs increased CK inhibitors of P450 cause increased statin toxicity
What is the effect of resins?
prevent recycling of bile acids in the ileum –> increased synthesis of bile acids by increasing cholesterol formation by the liver and increase LDL receptors
What are the side effects of Resins?
increased TGs within VLDL increased cholesterol gallstones GI--> constipation and bloating decreased fat soluble vitamin absorption decreased statin absorption
Ezetimibe
block intestinal absorption of cholesterol –> increasing cholesterol production and LDL receptors
What are the side effects of ezetimibe?
Diarrhea
increased LFTs
PCSK9 inhibitors
decrease the breakdown of LDL receptors
What are the two PCSK9 inhibitors ?
Alirocumab
evolocumab
Fibrates
activate PPAR-alpha to up regulate LPL
decreasing VLDL–>decreased LDL
increases HDL
What are the side effects of vibrates ?
myopathy
cholesterol gallstones
Niacin
increase HDL by 30%
decreases cAMP–> inhibit HSL
decrease VLDL
What are the side effects of niacin ?
flushing & warmth
hyperglycaemia
hyperurecemia
increased LFTs–> severe hepatotoxicity
What is the best way to counteract niacin side effects?
pretreatment with aspirins
