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Pharmacology > Cardiology: Lipid Metabolism > Flashcards

Cardiology: Lipid Metabolism Flashcards

1
Q

Describe the structure of a lipid protein.

A

Hydrophobic cholesterol ester centre.

Hydrophyllic coat of phospholipid, cholesterol and apoproteins

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2
Q

Which apoproteins are associated with chylomicrons?

A

Apo B48

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3
Q

Which apoproteins are associated with HDL?

A

Apo A1 and A2

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4
Q

Which apoproteins are associated with LDL?

A

Apo B100

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5
Q

Which apoproteins are associated with VLDL?

A

Apo B100

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6
Q

What is the purpose of Apo B lipoproteins?

A

Deliver tryglerides to muscles for ATP synthesis and for storage in adipocytes.

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7
Q

Where are chylomicrons formed?

A

Intestine

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8
Q

Where are VLDL formed?

A

Liver

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9
Q

What is the name of the receptor that allows cholesterol into the enterocyte during chylomicron formation?

A

Niemann Pick C1 like protein

NPC1L1

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10
Q

what mediates lipidation of chylomicrons?

A

MTP (microsomal tryglyceride transfer protein)

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11
Q

Where do chylomicrons travel after exiting the enterocyte?

A

Thoracic duct then subclavian vein

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12
Q

How are chylomicrons and VLDL activated?

A

Transfer of apo Cll from HDL

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13
Q

How are apoB proteins cleared?

A

They disocciate from LPL and ApoCll is transferred back to HDl in exchange fro apoE.
Return to the liver and are metabolised by hepatic lipase.
All apo B48 and half apoB100 are cleared by endocytosis of hepatocytes.
ApoB100 become LDL via IDL.
They now lack apoE.

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14
Q

What cholesterol causes atheromas?

A

LDL

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15
Q

What is the role of HDL in the body?

A

Removes excess cholesterol from cells by transporting it to the liver

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16
Q

Describe the process of atheroma formation.

A 
Epithelial damage
Uptake of LDL into endothelium-->OXLDL
Macrophages uptake OXLDL resuting in a fatty streak
Collagen is layed down.
Atheromatous plaque is formed.
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17
Q

What is primary dyslipidemia?

A

Dietary and genetic cause of lipid profile

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18
Q

What is secondary dislipidemia

A

Consequence of disease eg diabetes, alcoholism, liver disease

19
Q

What lipoprotein is elevated in type 1 primary dyslipidemia?

A

chylomicrons

20
Q

Type IIa?

A

LDL

21
Q

Type IIb

A

LDL and VLDL

22
Q

Type III

A

beta VLDL

23
Q

Type IV

A

VLDL

24
Q

Type V

A

chylomicrons and VLDL

25
Q

Name two statins.

A

Simvastatin

Atorvastatin

26
Q

What are statins?

A

HMG coA reductase inhibitora

27
Q

What do statins prevent the production of?

A

Mavalonate and thus cholesterol

28
Q

What effect does the decrease in cholesterol cause?

A

Increased LDL receptor expressiona nd enhanced clearing of LDL

29
Q

What are the other additional benefits of statins?

A

Decreased inflammation
Reversal of endothelial dysfunction
Decreased thrombosis
Stabilization of atheromatous plaques

30
Q

Give the adverse affects of statins

A

Myosiitis and rhabdomyolosis

31
Q

Name two fibrates.

A

Bezafibrate

Gemfibrozil

32
Q

When would you use a fibrate?

A

First line in patients with very high tryglyceride levels

33
Q

Which group of people should fibrates be avoided

A

Alcoholics

34
Q

Give the adverse effect of fibrates

A 
Myositis
Rhabdomyolosis
Gi symtoms
Pruritus
Rash
35
Q

What drugs inhibit cholesterol absorptions

A

Bile acid binding resisn

36
Q

Name three bile acid binding resins

A

Colestryamine
Colestipol
Colsevelam

37
Q

How do bile acid binding resins work?

A

Inhibit the reabsorption of bile salts
So more cholesterol must be converted to bile salts
Decreased absoprtion of triglycerides
Increased LDL receptor expression

38
Q

Give the adverse affect of bile acid binding resins

A

Adverse GI irritation

39
Q

What is ezetimibe

A

Inhibits the Niemann Pick C1 transport protein

40
Q

What effect does ezetimibe have on the lipid profile

A

Decreased LDL

LIttle change to HDL

41
Q

When is ezetimibe used?

A

In combo with a statin when the latter does not give adequate reponse

42
Q

Give the adverse effects of ezetimibe

A

Diarrhoea, abdo pain , headache

43
Q

When is ezetimibe contraindicated

A

Breast feeding females

Pharmacology (13 decks)

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