Dyslipidaemia Drugs Flashcards
What causes secondary dyslipidaemia?
type 2 diabetes, hypothyroidism, alcoholism, liver disease
What are the contraindications to ezetimibe?
breast feeding
What are statins used for?
first line to reduce LDL, also reduce total cholesterol and triglycerides, modestly increases HDL
What are the adverse effects of statins?
rare - incidence increased if combined with a fibrate, myositis - muscle inflammation and degeneration, rhabdomyolysis - destruction of striated muscle cells
What is the adverse effect of bile acid binding resins?
GI irritation
Give examples of bile acid binding resins
colestyramine, colestipol, colsevelam
How is ezetimibe administered?
orally
Give examples of lipid lowering drugs?
statins, fibrates
How are statins administered?
orally at night
What is the mechanism of action of fibrates?
agonists of nuclear receptors that enhance transcription of several genes
Give examples of fibrates
bezafibrate, gemfibrozil
What are the adverse effects of fibrates?
incidence greater than for statins, myositis - muscle tissue inflammation and degeneration, rhabdomyolysis - destruction of striated muscle cells, GI symptoms, pruritus - severe itching of the skin, rash
Give examples of statins
simvastatin, atorvastatin
What is the mechanism of action of bile acid binding resins?
more cholesterol converted to bile salts, decreased absorption of triglycerides
What causes primary dyslipidaemia?
diet and genetic factors
What are the adverse effects of ezetimibe?
diarrhoea, abdominal pain, headache
Give examples of drugs that inhibit cholesterol absorption
bile acid binding resins, ezetimibe
What do low density lipoproteins cause?
atherosclerosis
What are the other benefits of statins?
decreased inflammation, reversal of endothelial dysfunction, decreased thrombosis, stabilisation of atherosclerotic plaques
What is the role of high density lipoprotein?
removes cholesterol from cells - transports it to the liver where it is broken down
What are fibrates used for?
first line to decrease triglycerides, modest decrease in LDL, modest increase in HDL
How are bile acid binding resins administered?
orally
What is dyslipidaemia?
high levels of LDL and/or low levels of HDL, increases risk of CHD and stroke
What is the mechanism of action of statins?
competitive inhibitors of enzyme responsible for cholesterol synthesis in hepatocytes
What is the mechanism of action of ezetimibe?
reduces absorption of cholesterol, decreases LDL
