dyslipiedemia drugs Flashcards
what are dyslipidemic drugs used for?
to decrease blood lipids
prevent or delay the dev of atherosclerotic plaque
promote the regression of existing atherosclerotic plaque
reduce morbidity and mortality from cardiovascular disease
what is the total normal serum cholesterol?
<5.2nmol/L
what are HMG CCoA Reductase Inhibitors (Statins)
drugs that inhibit an ezyme required for hepatic synethsis of cholesterol
decrease total serum cholesterol, LDL, VLDL, and triglycerides
what is the most effective anti-lipedimic? ***
what are HMG CCoA Reductase Inhibitors (Statins)
what do statins do to HDLs?
remain unchanged or may increase
what do statins do to C-reactive protein?
reduce it associated with MI and stroke
when do you take a statin?
bedtime because produce most amount of lipids at night
what are some adverse effects of statins? ***
Hepatotoxicity, as evidenced by increase in aspartate transaminase (AST) (i.e. no statins with liver disease)
Myopathy, as evidenced by muscle aches, pain, and tenderness, may progress to myositis or rhabdomyolysis
Peripheral neuropathy, as evidenced by weakness, numbness, tingling, and pain in the hands and feet
medication and food interactions of statins? **
fibratates (gemfibrozil, fenofibrate) and ezetimibe inc the risk of myopathy
meds that suppress Cyp3A4 such as erythromycin and ketoconazole, can inc levels of statins when taken concurrently
grapefruit juice suppress CYP3A4 and can inc levels of statins
whats an example of a bile acid sequestrant?
cholestyramine (questran)
what do bile acid sequestrants (like cholestryamine) do?
bind bile acids in the intestinal lumen… loss of bile acid stimulates hepatic synethsis of more bile acids from cholesterol, reducing serum cholesterol, especially DL
what would bile acid sequestrants may be combined with?
statins to further reduce LDL
what are some AE for bile acid sequestrants?
I discomfort, constipation, and diarrhea, may cause gallstones ***
example of fibrate?
fenofibrate (lipidil)
what do fibrates do?
Increase the oxidation of fatty acids in liver and muscle tissue, decreasing hepatic production of triglycerides, VLDL, and increase HDL
which drug is the most effective for reducing serum triglycerides?
fibrates
fibrates may cause ___
gallstones
AE of fibrates?
GI discomfort, prolonged PTT, hot flash feeling
what drug dose must be reduced for fibrates???
***warfarin
what is niacin also known as?
vitamin b3
what does niacin do?
decreases cholesterol and triglycerides by inhibiting mobilization of free fatty acids frm peripheral tissues
what is the most effective drug for increasing HDL?
niacin
high doses of niacin cause what?
skin flushing, pruiritis, and gastric irritation ***
**may also cause hyperglycemia, hyperuricemia, elevated liver enzymes and hepatitis
example of cholesterol absorption inhibitor ?
ezetimibe (ezetrol)
what do cholesterol absorption inhibitors do?
Only agent in the newest class of dyslipidemic drugs
Reduces total cholesterol and triglycerides
not covered by BC PharmaCare, not carried by IH ->
BC ministry of Health determined it was not better or safer than statins
Expensive (30 day supply 218 US$)
what are some natural health products used for dec lipids?
Absorption of medication may be reduced with use of flax or flax seed
Garlic has little scientific support for use as dyslipidemic agent
Green tea is used as dyslipidemic, but caffeine may be CNS stimulant
Soy has been researched extensively as dyslipidemic, no big changes in LDL/HDL seen
