Antilipemic drugs Flashcards
What are the two forms of lipids in the blood, and what is usually the combination of a lipoprotein
The two forms are triglycerides and cholesterol. A lipoprotein is the combination of a triglyceride or cholesterol with a polipoprotein
What are the 4 types of lipoprotein
very low density which is produced by the liver, intermediate-density lipoprotein, low-density lipoprotein, high density lipoprotein which recyles cholesterol in blood
What is high cholesterol levels linked to?
High levels of cholesterol in the blood is linked to creating a greater risk of coronary heart disease
What are the classes of antilipemic drugs?
HMG-CoA reductase inhibitors (statins), bile acid sequestrants, B vitamin niacin, fibric acid derivatives, cholesterol absorption inhibitors
What are the examples for statin drugs?
Atorvastatin, rosuvastatin calcium
What is the MOA of statins
They lower blood cholesterol by decreasing the rate of cholesterol production. If less cholesterol is produced liver increases LDL receptors to take away LDL from blood circulation
What are HMG-CoA reductase inhibitors (statins) adverse effects
GI disturbance, rash headache, myopathy which may cause rhabdomyolysis,
What is rhabdomyolysis?
This is when there is a breakdown of muscle protein, causing muscle protein in the urine so discontinuation of statins is important.
What are drug interactions for HMG-CoA reductase inhibitors
Oral anticoagulants, drugs metabolizzed by CYP3A4
What is atorvastatin calcium and rosuvastatin and when are they dosed?
They are drus used to lower LDL cholesterol and raise HDL cholesterol levels. They are dosed in in the evening or at night
What is the main example of bile acid sequestrants?
Cholestyramine resin (olestyr)
MOA of bile acid sequestrants?
Since bile acids are needed for the absorption of cholesterol the drug prevents absorption of bile acids from the small intestine.
Indications for bile acid sequestrants
Type 2 hyperlipoproteinemia, relief of pruritus associated with partial biliary obstruction, used with statins
Bile acid sequestrant adverse effects?
Constipation, heartburn, nausea, bleaching, bloating,
Considerations for bile acid sequestrants
Overdose can cause obstruction, high doses may cause reduced absorption of fat-soluble vitamins
Contraindications for bile acid sequestrants
Hypersensitivity, pregnancy/lactation, loose bowel movements,
What is the MOA of niacin?
Decreases levels of trigylcerides, LDL and increases HDLs by inhibiting lipolysis and reducing metabolism of cholesterol and triglycerides
Contraindications for niacin
Peptic ulcer, hypertension, active hemorrhagic process
Niacin adverse effects?
Flushing, pruritus, gastrointestinal distress
What is an example of fibric acid derivatives (fibrates)
Gemfibrozil
MOA of fibric acid derivatives?
Activates lipoprotein lipase to breakdown cholesterol, suppresses release of free fatty acids, inhibits the synthesis of triglycerides, increase the secretion of cholesterol in the bile
Indications for fibric derivatives?
Treatment of type 3,4,5 hyperlipidemias
Contraindications for fibric acid derivatives
Drug allergy, severe liver or kidney disease, cirrhosis, gallbladder disease
Fibric acid derivative adverse effects?
Abdominal discomfort, blurred vision, risk of gallstones
What are interactions for fibric acid derivatives
They enhance the action of oral anticoagulants
What is an example of a cholesterol absorption inhibitor, and what does it do?
Ezetimibe. It inhibits absorption of cholesterol and related sterols from the small intestine and increases HDL cholesterol levels
What is garlic used for and its interactions?
It is an antispasmodic, antiseptic, antibacterial, antiviral, antihypertensive, and lipid reducer. It can cause increased bleeding when taken with NSAIDs
What are flax seeds used for?
Used for artherosclerosis, hypercholesterolemia, hypertriglyceridemia,GI distress, bladder inflammation
What is Omega 3 and what is it used for
It is a fish oil product used for cholesterol
