Atherosclerosis treatments Flashcards
What do statins inhibit?
Inhibit HMG-coA reductase
What are examples of specific reversible statins?
simvastatin, pravastatin, lovaststain
Examples of long lasting statins
atorvaststatin, rosovastatin
What is the result of statins on the body?
decrease cholesterol synthesis, increase LDLR synthesis, so decreases LDL in circulation and increases HDL. also increases NO availability which inhibits platelet aggregation and decreases inflammation
What does squalestatin do?
Inhibits squalene synthesis- a step in the cholesterol synthesis pathway
How do inhibitors of cholesterol absorption work?
block NPCIL1 transport protein, so decreases amount of circulating cholesterol by blocking intestinal absorption of it
How to sterols/stanols work?
structurally similar to cholesterol so is replaces cholesterol, this decreases amount of cholesterol absorbed into the blood, decreases LDL. also activates ABCG5/G8 transporter proteins in enterocytes- which increases movement of cholesterol into intestine
How to PCSK9 inhibitors work?
Binds PCSK9 so LDLR not degraded and LDL is taken up by liver.
how do resins work?
prevent bile acid absorption into blood, this decreases liver cholesterol, increases LDLR and decreases LDL levels
how do bile acid sequestants work?
decrease cholesterol in liver, stimulates apoB and E synthesis
how does niacin work?
converted to nicotinamide which inhibits VLDL secretion, resulting in decreases LDL and increased HDL in blood
what are cholesterol ester transfer proteins?
transfer cholesterol ester from HDL to LDL
what does inhibition of CETPs do?
decreases LDL, increases HDL and increases reverse cholesterol transport
what does acyl CoA acyl transferase do?
esterifies cholesterol to store in lipoproteins
How do fibrates work?
activate PPARs, induce transcription of genes that metabolise lipids. increases LPL expression. results in increased HDL by stimulating apoA1 synthesis
