Cholesterol Flashcards
Simvastatin
Statin
Short acting so given before bed to coincide with peak cholesterol in early morning.
What are the effects of oxidised LDL?
Inhibits macrophage motility
Indices T cell activation and VSMC division
Toxic to endothelial cells
Enhances platelet activation
Ezetimibe
Cholesterol lipase inhibitor
Stops uptake in brush border
Secondary up regulation of LDL receptors
Statins mechanism of action
Inhibit cholesterol production by hepatocytes (HMG CoA reductase)
Increase clearance of IDL and LDL (more LDL receptors)
Decreased production of VLDL and LDL
Statins ADRs
Increased transaminases (but not liver failure) Myopathy GI complaints Arthralgia Headaches
Secondary effects of statins
Anti inflammatory
Plaque reduction
Improved endothelial function
Reduced thrombotic risk
Pravastatin
Statin
Atorvastatin
Very good statin
Fibric acid derivatives mechanism
PPAR agonist- increased lipoprotein lipase
Reduced triglyceride production
LDL reduction depends on specific drug
Fibric acid derivatives indications
Adjunctive to diet
Hypertriglyceridaemia
Fibric acid derivatives ADRs
GI upset
Cholelithiasis
Myositis
Abnormal LFTs
Contraindications of fibric acid derivatives
Hepatic or renal dysfunction
Gallbladder disease
Nicotinic acid mechanism of action
Reduces VLDL and increases HDL
Inhibit lipoprotein A synthesis
Nicotinic acid ADRs
Flushing, itching, headaches Hepatotoxicity GI Peptic ulcers Hyperglycaemia Reduced insulin sensitivity
Ezetimibe mechanism
Decreased intestinal absorption
Increased hepatic LDL receptors
Decreased cholesterol content of atherogenic particles
Circulates enterohepatically
