Clinical Aspects of Lipids Flashcards
When should you measure lipids?
- MI
- CVA
- vascular disease
- acute pancreatitis
- family history
- clinical signs
What are lipids?
fats,
there are
triglycerides, (contain fatty acids) glycerophospholipids, (contain fatty acids)
sphingophospholipids, (contain fatty acids)
cholesterol
prostaglandins
What are the clinical signs of hypercholesterolaemia?
xanthomata - fatty deposits at the tendons
xanthelasma - white lumps around the eye
corneal arcus - ring around iris
milky blood/ serum
What is the measured in a lipid measure?
- total cholesterol
- HDL cholesterol
- triglycerides (as requested) affected by fasting but still useful
- calculate the HDL total cholesterol ration
- LDL cholestreol (if requested) triglycerides must be <4.5mmol/l - can be calculated
Why are statins such good treatment?
They lower cholesterol but they also inhibit the atherosclerotic mechanism and so reduce the development of atherosclerosis and can even sometime reduces the atherosclerosis in the arteries
Examples of Statins
pravastatin simvastain Atorvastatin Rosuvaststin Fluvastatin
Examples of PCSK9 inhibitors
Alirocumab
evolocumab
Classes of lipid lowering medications
Statins
PCSK9 inhibitors
fibrates
ezetimibe
What are the 2 main ways that statins can react with other drugs?
They can cause increased plasma levels of statins and cause rhabdomyolysis
They can cause decreased plasma levels of statins and so cause refractory increase or the sudden loss of efficacy of the statins
How do PCSK9 inhibitors work?
PCSK9 are involved in recycling LDL receptors in cells, they act as a brake blocking PCSK9 which increases the rate of LDLR recycling
What is a CV risk factor which can also case acute pancreatitis?
hypertriglyceridemia
the chylomicrons can abstruct the capillaries and lead to decreased perfusion in parts of the pancreas and causing local damage leading to acute pancreatitis
