Dyslipidaemias Flashcards
What are dyslipidaemias?
Conditions characterised by abnormal lipid levels in the bloodstream
What lipid abnormalities are commonly associated with dyslipidaemias?
Elevated total cholesterol
Elevated Low-density lipoprotein (LDL) cholesterol
What are the target values for total cholesterol?
Less than 5.0 mmol/L
What are the target values for HDL cholesterol in men and women?
Men: Greater than 1.0 mmol/L
Women: Greater than 1.2 mmol/L
What is the target value for LDL cholesterol?
Less than 4.0 mmol/L
Why is maintaining target lipid levels important?
To reduce the risk of atherosclerotic cardiovascular disease
What are the two classifications of dyslipidaemias?
Primary Dyslipidaemia
Secondary Dyslipidaemia
What causes primary dyslipidaemia?
Inherited mutations, commonly in the LDL receptor gene
What is a common condition associated with primary dyslipidaemia?
Familial hypercholesterolemia
What 3 factors are associated with secondary dyslipidaemia?
Dietary indiscretions
Other medical conditions
Side effects of medications
What 2 dietary habits can contribute to dyslipidaemias?
High in saturated fats
High alcohol consumption
Name 5 additional risk factors for dyslipidaemias.
Smoking
Lack of exercise
Obesity
Kidney or liver disease
Genetic predisposition
What total cholesterol level may raise suspicion of dyslipidaemia?
Exceeding 7.5 mmol/L
What is the primary treatment goal for individuals at high cardiovascular risk?
Reduce LDL cholesterol (LDL-C) by at least 50% from baseline
What is the first-line therapy for dyslipidaemias?
Statins (e.g., atorvastatin or rosuvastatin)
What is the mechanism of action of statins?
Inhibit HMG-CoA reductase, reducing hepatic cholesterol production
What are 2 common adverse effects of statins?
Headache
Gastrointestinal disturbances
What 3 precautions should be taken when using statins?
Hepatic impairment
Renal impairment
Pregnancy/Breastfeeding
What are the 2 common adverse effects of ezetimibe?
Gastrointestinal disturbances
Headaches
What is the mechanism of action of ezetimibe?
Inhibits the NPC1L1 transporter in the small intestine, reducing cholesterol absorption
Ezetimibe should be avoided during breastfeeding. True or False?
True
What 3 drugs can interact with statins?
CYP450 inhibitors
Amlodipine
Clarithromycin
True or False: Ezetimibe can potentiate the effects of warfarin.
True
If statins are contraindicated or not tolerated, what is the indicated alternative?
Ezetimibe
What are the high-intensity doses for atorvastatin and rosuvastatin?
Atorvastatin: 40–80 mg
Rosuvastatin: 20–40 mg
What is a significant consideration when prescribing atorvastatin versus rosuvastatin?
Atorvastatin is preferred in older individuals and certain populations due to lower risk of adverse events
What are 3 more serious but rare adverse effects associated with Statin use?
Muscle aches and myopathy
Rhabdomyolysis
Drug-induced hepatitis
Mnemonic : 5 total, 4 LDL, 1/1.2 HDL
TC less than 5.0 mmol/L
LDL less than 4.0 mmol/L
HDL should be greater than 1.0 mmol/L in men and 1.2 mmol/L in women
Statin AE
Mnemonic: D-HARM
Drug induced Hepatitis
Headache
Abdominal Disturbances
Rhabdomyolysis
Muscle aches/myopathy
Statin Interactions
Mnemonic: DIG MAC
Diltiazem
Itraconazole
Grapefruit juice
Macrolides
Amiodarone
Clarithromycin
Ezetimibe Precautions & Interaction
Mnemonic: B-P and C-FW
B-P - Avoid in breastfeeding and caution in pregnancy
C-FW - Ciclosprin, fibrates and warfarin
