Drugs For Hyperlipidemia Flashcards
Primary dietary factors that contribute to elevated plasma lipoproteins
Cholesterol
Saturated fats
Chylomicrons or LDL
Premature atherosclerosis: increased ___________
Acute pancreatitis: increased ___________
LDL
Chylomicrons
Alcohol raises _______ and ________ levels and should be avoided in pxs with high __________
TG and VLDL
TG
Drugs most effective at lowering LDL
Statins
Resins
Ezetimbe
Niacin
Drugs most effective at lowering TG and VLDL and raising HDL
Niacin
Fibrates
Increases number of high affinity LDL receptors which clear LDL and VLDL temnants from the blood
Inhibits hepatic cholesterol synthesis
Drug, Class
Simvastatin, HMG-CoA Reductase Inhibitor
Atorvastatin, Rosuvastatin, Fluvastatin, Pravastatin, Lovastatin, Pitavastatin
Reversible competitive inhibitor of HMG-Coa reductase
Increased hepatic cholesterol uptake
Increased HDL, Decreased LDL
Drugs for High LDL
SE: Hepatotoxicity, myopathy, risk for rhabdomyolysis when used with fibrates
Drug, Class?
Simvastatin, HMG-CoA Reductase Inhibitor
Atorvastatin, Rosuvastatin, Fluvastatin, Pravastatin, Lovastatin, Pitavastatin
Why are statins given at night?
Cholesterol synthesis predominantly occurs at night
Binds bile acids and prevent their intestinal absorption, diverting hepatic cholesterol to bile acid synthesis
Increase in HDL, decreases LDL (modest)
Class?
Bile Acid Binding Resins
Binds bile acids, increasing cholesterol use for their replacement
Modest lowering of LDL
Drug for hypercholesterolemia (high LDL) pruritus in cholestasis
SE: constipation, bloating, steatorrhea
Increases TGs and VLDL in patients with high TGs
Avoid in pxs with diverticulitis
Side effect of constipation can be treated with fiber supplements/psyllium
Drug, Class
Cholestyramine, Bile Acid Binding Resins
Colesevelam, Colestipol
Inhibits NPC1L1 transporter (in the jejunal enterocyte) that mediates gastrointestinal uptake of cholesterol and phytosterols
Drug for high LDL
SE: hepatotoxicity (increases with statin use)
Synergistic LDL lowering effect with statins
Drug, Class
Ezetimibe, Cholesterol absorption blocker
Cholesterol analog
Takes the place of dietary and biliary cholesterol
Drug for high LDL
SE: GI upset, bloating
Drug, Class
Sitosterol, Sterol absorption blocker
Most effective agent for increasing HDL levels
Reduces LDL cholesterol, triglycerides and VLDL
SE: flushing, hyperuricemia, impaired glucose tolerance, arrhythmia
Avoid in pxs with PUD
Potentiates effects of anti-hypertensives
Niacin, antihyperlipidemic drug
Pre-treatment with _________ causes reduction of flushing as a side effect of Niacin
Aspirin
Drugs that cause flushing
VANC Vancomycin Adenosine Niacin CCB
