Fibrates , Niacin

Question 1

Name Fibrates

Answer 1

Gemfibrozil
(“Gem-fibrozil jellyfish”)

Fenofibrate

Question 2

Fibrates MOA

(“Gemfibrozil jellyfish”)

Answer 2

-fibrates activate PPAR-alpha to upregulate LPL

-increase hydrolysis of VLDL and chylomicron triglycerides via LPL fibrates decrease serum triglycerides
(“Trident passengers escape airship”)

-fibrates stimulate LPL and reduce hepatic VLDL secretion decrease serum VLDL 35-50%
(“Gem-Fibozil jellyfish takes down airship”)

-decrease serum LDL (mild effect) by reducing VLDL
(“Gem-fibrozil jellyfish sinks ship”)

-fibrates increase serum HDL (mild effect) by activation of apolipoproteins A1 and A2 that will create nascent HDL’s
(“Elevates High density submarine”)

(“Lighthouse keeper lighting newsPPAR signal”)

Question 3

Fibrates Adverse effects

Answer 3

-fibrates can cause cholesterol gall stones
(“Sea”gall” stones”)

-Fibrates combines with statins increases risk of myopathy
(“Elevated statin-punk eating crispy chicken”)

Question 4

Niacin (vitamin B3) MOA

(“Loch Niacin monster”)

Answer 4

-MOST EFFECTIVE drug for increasing serum HDL (~30%)
(“Elevate High Density submarine”)

-niacin decreases serum triglyceride (reduces hepatic VLDL secretion)
(“Trident passengers escape airship”)

-Niacin decreases serum VLDL
(reduces hepatic secretion)
(“Loch Niacin monster takes down airship”)

-Niacin decreases serum LDL (mild effect) by lowering VLDL
(“Loch Niacin monster sinks ship”)

Question 5

Niacin Adverse Effect

(“loch niacin monster”)

Answer 5

-can cause cutaneous flushing and warmth → prostaglandins (cause flushing) is a mediator of vasodilation and inflammation
(“Red fiery furnace”)
(“Pro slugger bat”)

• ​NSAIDs (including aspirin) can be used to prevent flushing from niacin
  (“Fire extinguisher”)

-niacin can cause hyperglycemia
(“Elevated candy”)

-niacin can cause hyperuricemia (can precipitate gout)
(“Yellow knitting needles”)

-can cause elevated liver function tests (LFT’s) leading to severe hepatotoxicity, requires monitoring
(“Raised LFT Flag”)

Question 6

what is the benefit of including fish in your diet?

Answer 6

-fish oils are high in omega 3 fatty acids and can lower serum triglycerides
(by decreasing VLDL and apoB production)

(“Omega fish leaking oil”)
(“Sunken tridents”)