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Drugs: From molecule to man > ELM11: Hyperlipidaemias > Flashcards

ELM11: Hyperlipidaemias Flashcards

1
Q

What are lipoproteins?

A

Transport proteins in plasma
Composed of lipids phospholipids cholesterol and proteins

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2
Q

What is the structure of a lipoprotein?

A

Phospholipids in outer layer with embedded proteins and cholesterol and triglycerides in the centre

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3
Q

What are the 3 different types of density of lipoprotein?

A

HDL
LDL
VLDL

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4
Q

What involvement do LDL and VLDL have with atherosclerosis?

A

Formation of fatty streaks
Inhibit fibrinolysis
Activate platelets and increase aggregation
Increase atherosclerosis risk

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5
Q

What involvement do HDL have with atherosclerosis?

A

Increase fibrinolysis
Increase prostacyclin formation which decreases aggregation
High HDL/LDL ratio lowers atherosclerosis risk

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6
Q

What is hyperlipidaemia?

A

Too much lipid in the blood

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7
Q

What is familial hypercholesterolaemia?

A

Defect in LDL receptor or ApoB protein
High atherosclerosis risk
Treated with statins or other drugs

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8
Q

What are the two components you might seen in a microscope photo of an atherosclerotic plaque?

A

Small dark areas showing nuclei
Foam cells

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9
Q

How do macrophages become foam cells?

A
  1. Excess LDL in circulation enters intima of blood vessel and gets oxidised
  2. Immune cells enter intima and turn into macrophages
  3. Macrophages take up oxidised LDL and turn into foam cells
  4. Release cytokines and other growth factors that recruit smooth muscle cells
  5. Foam cells attach to endothelium and form fatty streak
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10
Q

How do lipid lowering drugs work to treat hyperlipidaemia?

A

Aim to lower LDL and VLDL and increase HDL

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11
Q

What are classed as lipid lowering drugs?

A

Statins
Ezetimibe
Fibrates
Exchange resins
Nicotinic acid

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12
Q

How do statins treat hyperlipidaemia?

A

Inhibit HMG-CoA reductase which is the enzyme in production of cholesterol
Reduce liver production of cholesterol
Lower cholesterol causes more LDL receptors
Increase removal of LDL from plasma
Increase HDL
Lower triglycerides

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13
Q

What are some problems of statins?

A

Myositis
Rhabdomyolysis
Altered liver function tests

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14
Q

What is ezetimibe?

A

Inhibits intestinal cholesterol absorption by inhibiting a cholesterol transporter in the gut
Causes reduced LDL and total cholesterol

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15
Q

What are some other drugs that can treat hyperlipidaemias?

A

Anion exchange resins
Fibrates
Nicotinic acid

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16
Q

How can fish oils be used to treat hyperlipidaemias?

A

Rich in unsaturated fatty acids
Reduced plasma triglycerides and platelet aggregation
Increases cholesterol

17
Q

What is olestra?

A

Fat substitute that can’t be absorbed by GI tract

18
Q

What are some side effects of olestra?

A

Malabsorption of fat soluble vitamins
Diarrhoea
Compensatory eating
Anal leakage

Drugs: From molecule to man (21 decks)

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