Dyslipidaemias Flashcards
What are statins?
Lower cholesterol levels
If statins don’t regulate cholesterol, what else can you use?
Ezetimbe
(Lipid regulating drug)
What are the three lipid abnormalities?
Low density lipoprotein cholesterol (LDL-C)
Triglycerides (TG)
Or both
High total cholesterol (TC)
What is the complication of hyperlipidaemia?
CVD
Atherosclerosis
What’s hypercholesterolaemia?
Elevated levels of Tc or LDL or both
What is hypertriglyveridaemia?
Elevated levels of Triglycerides
What is familial hyperlipidaemia?
Elevated serum lipids due to genetic defects in lipid metabolism
What is the difference between HDL and LDL?
HDL helps remove excess cholesterol from the bloodstream reducing risk of atherosclerosis while,
LDL they get elevated and contribute to the development of atherosclerosis, increased CVD such as stroke and heat attacks
What causes hyperdyslipidaemia?
Genes (familial)
T2D, obesity, smoking,alcohol,drugs,hypothyroidism,nephrotic syndrome,cholestasis
Very high lipid can affect what part of your body?
Eye
Skin
Elbow
List the three things that you can get due to having high lipid level?
Xanthelasma
Corneal arcus lipemia
Tendon xanthoma
What is xanthelasma
Yellow cholesterol deposits around the eyelids
What is corneal arcus lipemia?
White of grey ring that appears around the peripheral cornea
What is tendon xanthoma
Enlargement of tendons around knuckles
List examples of statins
Atorvastatin
Simvastatin
Fluvastatin
Rosuvastatin
Etc
List examples of fibrates
Fenofibrate
Clofibrate
Gemfibrozi
List examples of other lipid lowering drugs
Ezetimibe
Bempedoic acid
Nicotinic acid
Evinacumab
List examples of bile acid sequestrants
Cholestyramine
Colestipol
What is the first line treatment?
Statins
How does statins work?
Lowers LDL cholesterol by inhibiting HMG-CoA reductase
How does statins work?
Lowers LDL cholesterol by inhibiting HMG-CoA reductase
What do you use when statins are not tolerated or when cholesterol levels not achieved?
Ezetimibe
As mono therapy or in combination with statin
Why do we not use bile acid sequestrants?
Limited use
Poor tolerability and compliance
Declining use
When do you use fibrates ?
Consider if dietary interventions and statins and ezetimibe are not tolerated
Use under specialist supervision
How are fibrates beneficial?
May be beneficial in those with low HDL cholesterol or raised triglycerides
If you combine statins and fibrates, what happens?
Increase risk of muscle related side effect (Rhabdomyolysis)
What happens when you combine statins with fibrates
Increased risk of muscle related side effects (Rhabdomyolysis)
Eg gemfibrozil
Lost drugs for primary heterozygous familial hypercholesterolaemia whose LDL-cholesterol has not been adequately controlled on maximum tolerated lipid-lowering therapy?
Alirocumab
evolocumab
Patient should undergo a lipid lowering check after how many months?
3 months
What is the target of reducing non HDL cholesterol?
40%
High strength of simvastatin (80mg) causes what?
Myopathy
Which statins should be taken in the morning?
Rosuvastatin
Atorvastatin
List medium intensity drugs?
Atorvastatin 10mg
Simvastatin 20, 40mg
Fluvastatin 80mg
Rosuvastatin 5mg
List low intensity drugs?
Fluvastatin 20, 40mg
Pravastatin 10,20,40mg
Simvastatin 10mg
When do you give people 80mg simvastatin
hypercholesterolaemia and high risk of cardiovascular complications who have not achieved their treatment goals on lower doses
