Antilipidemics Flashcards
What are the five classes of antilipidemics drugs
HMG-CoA reductase inhibitor
Vitamin B3
Bile Acid Sequestrants
Cholesterol Absorption Inhibitor
PCSK9 inhibitors
What are the prototypes of the five classes of antilipidemics drugs
HMG-CoA reductase inhibitor =
Vitamin B3 =
Bile Acid Sequestrants =
Cholesterol Absorption Inhibitor =
PCSK9 inhibitors =
HMG-CoA reductase inhibitor = Atorvastatin
Vitamin B3 = Nicotinic acid
Bile Acid Sequestrants = Cholestyramine
Cholesterol Absorption Inhibitor = Ezetimibe
PCSK9 inhibitors =
-alirocumab
-evolocumab
What is the action of atorvastatin
- Inhibits HMG-CoA reductase, an enzyme needed for cholesterol synthesis
- reduces LDL receptors
What are the uses of atorvastatin
hypercholesterolemia
prevention of cardiovascular events
diabetes mellitus prevention
What are the precautions of atorvastatin
-effects are dose-dependent
-pregnancy category X
What are the adverse effects of atorvastatin
myopathy/rhabdomyolysis
hepatotoxicity
What is the action of nicotinic acid
-decrease production of VLDLs
-decreases triglycerides and LDLs
-increases HDL best
What are the uses of nicotinic acid
-lowering triglyceride levels in pancreatitis
-approved for elevating HDL
What are the precautions of nicotinic acid
-raise homocysteine levels
-risk of CHF
What are the adverse effects of nicotinic acid
-flushing
-GI distress
-hepatotoxicity
-hyperglycemia
-gouty arthritis
-hot flashes
What is the action of cholestyramine
-binding resin of bile acid
-prevents absorption of LDL
-increases LDL receptors on hepatocytes
What are the uses of cholestyramine
-combined w/ statins
-safer than all lipid-lowering meds
- devoid of systemic effects
What are the precautions of cholestyramine
bind w/ other drugs
Take about 4 hrs apart!
What the adverse effects of cholestyramine
-constipation, bloating
-decreased absorption of fat-soluble vitamins
What is the action of ezetimibe
-Inhibits cholesterol absorption at the small intestine’s brush border.
What are the uses of ezetimibe
- reduces LDL cholesterol
- those intolerant of statins
- Does not affect heart attack or stroke risk.
What are the precautions of ezetimibe
-allergy, rash, angioedema, and anaphylaxis
What are the adverse effects of ezetimibe
- muscle pain, tenderness, weakness or cramps
What is the action of alirocumab/evolocumab
-human monoclonal antibody
-Inhibits PCSK9, a protein that degrades liver LDL receptors, increasing LDL removal from the blood.
What are the uses of alirocumab/evolocumab
-hyperlipidemia refractory to other meds
(High cholesterol or fat in the blood that doesn’t get better with standard medicines.)
What are the precautions of alirocumab/evolocumab
-allergic reactions
-hypersensitivity vasculitis
What are the adverse effects of alirocumab/evolocumab
-risk of infections
-nasopharyngitis
-upper respiratory infections
-urinary tract infections
