CV Dyslipidemia

Question 1

Bile-acid Binding Resins

Answer 1

bind bile acid, E in stool and depleted, stimulates LDL R production in liver, extracted from blood, works entirely in GI. decrease LDL, increase TG (downside), increase HDL. treat extremely high LDL, can be for young people. Adverse constipation. combine with statins, interferes with absorption other drugs

Question 2

Statins

Answer 2

inhibit HMG-CoA reductase, stimulates LDL R production/removal from blood. decrease LDL/TG, increase HDL. widely used 1°/2° prevention coronary artery disease. Adverse myopathy, hepatotoxicity. improve endothelial cells, enhance plaque stability, inhibit platelet aggregation

Question 3

Cholesterol Absorption Blockers (Ezetimibe)

Answer 3

inhibits cholesterol transport, reduced chylomicron delivery to liver, LDL removal from blood. decrease LDL/TG, increase HDL. adjunct w/statins. contra bole acid binding resins

Question 4

Niacin

Answer 4

inhibits TG lipolysis in fat by inhibiting adenyl cyclase - decrease transport FA to liver, enhances reverse cholesterol transport to liver. decrease LDL/TG, best increase HDL. treat hypertriglyceridemia and low HDL. Adverse flushing, hepatotoxicity, insulin R. increases risk statin induced myopathy

Question 5

Fibrates

Answer 5

bind PPARα, stimulates FA oxidation. slight decrease LDL (may increase), big decrease TG, increase HDL. treat severe hypertriglyceridemia in diabetes, variable effects. Adverse hair loss, increases risk statin myopathy. inhibit coagulation, promote fibrinolysis