Cholesterol Flashcards
describe the formation of an atheroma
- LDLs deposit in tunica intima
- LDLs oxidised by macrophages to form foam cells giving a bulge
- migration of smooth muscle cells to form a fatty streak
- fibrous cap forms to give a plaque
- centre of the plaque may die and cholesterol may be given off by dead cells
what is the function of statins
inhibit HMG CoA Reductase so less cholesterol is produced
when is lipid lowering therapy given
when the patient has an increased risk of cardiovascular disease or has familial hypercholesteremia
what are the adverse effects of statins
hepatic injury - giving a rise in ALT
myopathy - muscle pain and breakdown leading to rhabdomyolysis
what would be seen in the blood tests of a patient suffering from adverse effects of statins
creatine kinase
raised ALTs
when do adverse side effects from statins occur
when using high doses of statins over a long period of time
what are the secondary benefits of statins
anti-inflammatory effects, plaque reduction, reduced thrombus risk
what does Nictoinic Acid do
reduces VLDL levels and increases HDL levels
what is nicotinic acid given with an why
aspirin as this helps with the side effects
what adverse effects are seen with nicotinic acid
headache, itching, peptic ulcers, hepatic toxicity
what do Fibrates do
reduce TAGs by increasing the production of lipoprotein lipase enzymes
what adverse when you give fibres with statins
you have an increased chance of developing the adverse effects of rhabdomyolysis and myopathy
what does ezetimibe do
inhibits the absorption of cholesterol in the intestines and increases the hepatic expression of LDL receptors
what should the cholesterol level be under normally
under 5 mmol/L
what non-drug lipid lowering treatments are there
plant sterols, fish oil, vitamins C/E, fibre
