Drugs Flashcards
What are the classes of drugs used to treat elevated blood lipids?
- HMG-CoA Reductase Inhibitors (Statins)
- Bile Acid Sequestrants
- Nicotinic Acid
- Cholesterol Absorption Inhibitors
- Fibric Acid Derivatives
What do HMG-CoA Reductase Inhibitors (Statins) do?
They inhibit the enzyme HMG CoA reductase, which is the rate determining step of hepatic cholesterol synthesis, causing a increase in the number of hepatic LDL receptors there are
What are the results of taking Statins?
- decreased LDL cholesterol because there are more receptors
- increased HDL cholesterol
- decreased triglycerides
What are the different types of Statins?
- Atorvastatin
- Rosuvastatin
What is important to consider before giving Rosuvastatin to a pt?
in Asian pts the plasma conc. of rosuvastatin is two times higher than Caucasian pts. so dosing should start as low as 5mg and increase gradually
What are the adverse effects of Statins?
- myopathy (muscle injury)
- rare: Rhabdomyolysis
What is Rhabdomyolysis?
muscle lysis with severe muscle pain
- includes the muscle cell releasing increased amounts of creatine kinase into the blood stream, with hyperkalemia and potential kidney failure
How is Rhabdomyolysis diagnosed?
by measuring the blood levels of the muscle enzyme creatine kinase
In what population should Statins not be used in and why?
Those who are pregnant or trying to become pregnant
- because cholesterol is required for the synthesis of cell membranes and many hormones
What is Nicotinic Acid (Niacin) and what does it do?
Vitamin B3, that is used to lower “bad cholesterol” (LDL) and triglycerides, and elevate levels of “good cholesterol”, HDL
When is Niacin typically used?
In pts that have a higher risk of heart attack (myocardial infraction) due to their high cholesterol and history of heart attacks
What are the adverse effects of Niacin?
- flushing
- NV
- diarrhea
- abnormal liver function tests
- cough
- itching
- rash
- dry skin
- head ache
What do Bile Acid Sequestrants do?
They attract and bind to bile acids, and prevent their absorption, causing for an increased demand for bile acids and the increase of their production in the live. LDL cholesterol is required to produced bile acids, so there is an increase in LDL receptors, then increased LDL uptake, and therefore a decrease in LDL cholesterol in the plasma
What are the adverse effects of Bile Acid Sequestrants?
Constipation and bloating
What is Ezetimibe (Zetia)?
