Dyslipidemia - Treatment Flashcards

1
Q

What are primary and secondary disorders?

primary disorders

A

primary disorders
- are caused by genetic mutations (familial) or a mix of genetic and environmental factors
= familial hypercholesterolaemia, polygenic lipid disorders

secondary disorders
- disorders that occur secondary to other factors such as drug treatment or other diseases
= hypothyroidism, type 2 diabetes, thiazide diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are primary and secondary interventions?

A

primary intervention
- prevention of initial cardiovascular events

secondary intervention
- prevention of a secondary cardiovascular event
= are prescribed after the first CV event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the purpose of lipid modifying treatments? What are the different types?

A

they reduce the circulating levels of atherogenic lipids
- triglycerides and lipoproteins

slow, reverse or prevent the development of atherosclerotic lesions (fatty streaks)

reduce the long term risk of CV disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the pathways in which lipid modifying treatments can act?

A

endogenous pathway
- statins, PCSK9 inhibitors, fibrates
= decrease production and increase uptake into tissues

exogenous pathway
- cholesterol absorption inhibitors
= decrease absorption from dietary sources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are statins? What is their purpose?

A

atorvastatin
simvastatin

treatment of

  • primary prevention of arterial disease
  • secondary prevention of adverse cardiovascular event
  • familial hypercholesterolaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do statins act?

A

act as HMG-CoA reductase inhibitors
- HMG-CoA reductase is an enzyme which is needed in the production of cholesterol
= is the rate limiting step

lowers circulating levels of cholesterol by

  • reaching production of cholesterol
  • increasing production of LDL receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the side effects of statins?

advantages and disadvantages

A

advantages

  • improve endothelial function
  • reduce vascular inflammation
  • reduce platelet aggregation
  • anti-thrombotic

disadvantages

  • myalgia (muscle pain)
  • type II diabetes
  • liver damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are fibrates? What is their purpose?

A

bezafibrate
gemfibrozil

treatment of

  • mixed dyslipidemia
  • severe resistant dyslipidemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do fibrates act?

A

increase the concentration of lipoprotein lipase
- increase breakdown of vLDL and chylomicrons

increased uptake into tissues

enhances expression of LDL receptors
reduced vLDL release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are PCSK9 inhibitors? What is their purpose?

A

evolocumab
alirocumab
= are both monoclonal antibodies

treatment of

  • familial hypercholesterolaemia
  • statin resistant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do PCSK9 inhibitors work?

A

inhibits PCSK9 protein

- prevents PCSK9 from binding to LDL receptors therefore stopping LDL receptor degradation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are cholesterol absorption inhibitors? What is their purpose?

A

ezetimibe

bile acid binding resins - colestyramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are cholesterol absorption inhibitors? How do they act?

A

ezetimibe

binds to cholesterol transporter in the duodenum
- prevents the uptake of cholesterol from the diet
= is excreted as faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are bile acid binding resins? How do they act?

A

colestyramine

bind to bile acids in the intestine
- bile acids contain cholesterol
= HDL transports excess cholesterol to the liver
- resins binding means they are excreted as faeces while more bile acids are made from plasma cholesterol
= bile is typically reabsorbed from the blood by the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly