Dyslipidemia Drugs: Fibrates and Niacin Flashcards
Triglycerides in VLDLs are hydrolyzed by
LPL
Triglycerides in VLDLs are hydrolyzed by LPL releasing
free fatty acids
Free fatty acids can be used for
energy by heart and skeletal muscle
Free fatty acids can be converted back into
triglycerides and stored in adipose tissue
Fibrates are
- Gemfibrozil
2. Fenofibrate
Fibrates activate
PPAR-alpha
Fibrates activate PPAR-alpha to
upregulate LPL
Fibrates decrease
- Serum triglycerides
- Serum VLDL
- Serum LDL
Fibrates decrease serum VLDL
35-50% by stimulating LPL and reduced hepatic VLDL secretion
Fibrates decrease serum triglycerides
increase hydrolysis of VLDL and chylomicron triglycerides via LPL
Fibrates decrease serum LDL by
reducing VLDL
Fibrates have a mild effect on ______
- LDL
2. HDL
Fibrates increase serum
HDL
Fibrates combined with statins increases risk of
myopathy
Fibrates side effects
Cholesterol Gall Stones
Niacin is also known as
Vitamin B3
Niacin is the most effective drug for
increasing serum HDL (~30%)
What is the most effective drug for increasing serum HDL
niacin
Niacin decreases serum
- Triglycerides
- VLDL
- LDL
Niacin decreases serum triglycerides
reduces hepatic VLDL secretion
Niacin decreases serum VLDL
reduces hepatic VLDL secretion
Niacin decreases serum LDL by
lowering VLDL
Niacin has a mild effect on
LDL
Niacin side effects
- Cutaneous flushing and warmth
- Hyperglycemia
- Hyperuricemia and precipitate gout
- elevated liver function tests (LFTs) leading to severe hepatotoxicity (requires monitoring)
Why does Niacin cause flushing
Prostaglandins
_______ can be used to prevent flushing from niacin
NSAIDs (including aspirin)
Fish oils are
omega-3-fatty acids
Fish oil can
lower serum triglycerides (by decreasing VLDL and apoB production)
