Drug Therapy For Dyslipidemia Flashcards
What are the three lipoproteins involved in atherosclerosis?
- Very Low Density (VLDL)
- Low Density (LDL)
- High Density (HDL)
Which lipoprotein is protective against Atherosclerosis?
HDL
What lifestyle changes can be used to treat LDL?
TLC (therapeutic lifestyle changes) Diet Exercise Smoking Cessation Weight Control
HMG-CoA Reductase Inhibitors
MOA: inhibit of HMG-CoA reductase enzyme, needed for cholesterol synthesis
Used in diseases: decrease MI, stroke, and heart failure
Lower LDL
ending “statin”
Adverse Effects of HMG-CoA Inhibitors
Mild headache, rash, GI disturbances Myopathy and rhabdomyolysis Possible with ALL statins Measure CK at baseline and repeat if patient complains of muscle pain and weakness Hepatotoxicity Rare Measure LFTs at baseline Memory Loss Transient True incidence and correlation unclear Cataracts
Drug-Drug Interactions of HMG-CoA Inhibitors
other lipid-lowering drugs
drugs that inhibit CYP3A4
Bile Acid Sequestrants
MOA: bind to bile acids and prevent their physiologic action
Physiological effect: decrease LDL, Increase HDL, possible transient increase in TG
starting with “coles”
For what diseases are BAS used
adjunct therapy to decrease LDL
Counseling Points of BAS
Bind to other medications in GI tract and prevent absorption
Separate administration of other drugs by 1 hour before or 4 hours after BAS
Take with food and water
Adverse Effects of BAS
Constipation
Nausea
Bloating
Ezetimibe MOA
decrease reabsorption of cholesterol in the small intestines, add-on therapy for LDL, management of cholesterol
Physiologic effect of Ezetimibe
Decrease Total cholesterol
Decrease LDL (19%)
Decrease TG (5-10%)
Possible modest increase in LDL
Adverse effects of Ezetimibe
Rare – myopathy and rhabdomyolysis, hepatitis
Fibric Acid Derivatives
most effective drugs for lowering TG levels
third-line agents for lowering lipid levels,
mid - “fibr”
Fibric Acid Derivatives MOA
Stimulate lipoprotein lipase via activation of PPAR-alpha
