BCGP Hyperlipidemia Flashcards
which of the statins is not associated to reduce LDL and total cholesterol in pt with familial hypercholesterolemia
lovastatin
which immunosupressive agent improve lipid panel
cyclosporin
Formula LCL-C
LDL-C = (TC) – (triglycerides/5) – (HDL-C).
LDL lowering drugs
statins
ezetimibe,
bile acid sequestrants, and
PCSK9 inhibitors
TG lowering drugs
niacin and fibrates (have mild ldl lowering action)
High intensity statins
lowers by 50%
rosuvastatin 20mg and 40mg
atorvastatin 40 and 80mg
moderate intensity statins
30-49%
Atorvastatin 10 mg (20 mg)
Rosuvastatin (5 mg) 10 mg
Simvastatin 20–40 mg§
Pravastatin 40 mg (80 mg) Lovastatin 40 mg (80 mg) Fluvastatin XL 80 mg Fluvastatin 40 mg BID Pitavastatin 1–4 mg
low intensity statins
<30%
simvastatin 10mg
Pravastatin 10–20 mg
Lovastatin 20 mg
Fluvastatin 20–40 mg
ezetimibe
lowers LDL-C levels by 13% to 20%
bile acid
reduce LDL-C levels by 15% to 30%
not abs system
causes constipation
can cause severe hypertriglyceridemia
75 years of age or younger with not high risk ASCVD
high-intensity statin therapy should be initiated or continued with the aim of achieving a 50% or greater reduction in LDL-C levels
75 years of age or younger with non high risk clinical ASCVD on max statins and LDL >70
add ezetimibe
75+ yo and non high risk ASCVD
moderate intensity statins
high risk ASCVD
initiate high intensity, high dose statins
if LDL-C still above 70, add ezetimibe OR if consider PCSK9 - add ezetimibe first, then PCSK9
40-75yo with DM
moderate intensity statins
LDL-C >190
high intensity statins
0-19yo with familial HLD
statins
20-39yo, familial HLD and LDL-C >160
consider statin
40-75 yo
LDL-C 70-190 without dm
has ASCVD < 5 (low risk)
life style change
40-75 yo
LDL-C 70-190 without dm
has ASCVD 5-7.5 (border line)
risk discussion
consider moderate statins
40-75 yo
LDL-C 70-190 without dm
has ASCVD 7.5-20 (intermediate risk)
risk discussion
consider statins with 30-49 % reduction
40-75 yo
LDL-C 70-190 without dm
has ASCVD > 20 (high risk)
risk discussion and statins >50%
20+ yo TG 175- 500
life style change
40-75 yo with ASCVD > 7.5 TG < 500
life style, consider statin
