Hyperlipidemia Flashcards
What two components of lipids are increased
Cholesterols and triglycerides
Clinical signs?
• xanthomas
• fatty deposits around the cornea (brown ring)
• fatty deposits in liver
• CVD: eg stroke, cornonary artery disease
List the drugs used in lipid disorders
• HMG-CoA reductase inhibitors - statins
• fibric acid derivatives- fibrates
• bile acid sequestrants- renins
• nicotinic acid derivatives- vitamin b3
• cholesterol absorption inhibitors
Diagnosis for dyslipidemia
TG and cholesterol in fasting blood samples
Lipid management for primary and secondary prevention of CVD
What is the initial tests - baseline assessment
Take a non-fasting full lipid profile test
• total cholesterol
• HDL-C
• None HDL-C
• LDL
• TG
+
HbAlc
Who falls into the primary prevention category?
• <85 with 10% qrisk
• T2DM with 10% qrisk
• T1DM with one or more of
- had for over 10 years
- nephropathy
- 40+
• CKD - eGFR <60
• >85
What primary management
Give lifestyle first
If not then - atorvastatin 20mg
(Identify and address of risk factors, eg smocking and alcohol)
When full lipid profile is tested again after 3 months and non HDL-C has not reduced from 40% from baseline. What to do?
Increase dose, to eventually 80mg OD
If max tolerated dose is not reducing non-HDL from 40% from baseline after 3 months, what do to?
Add Ezetimide 10mg
(Can be given alone)
Who falls into the secondary prevention category
Established CVD
What is secondary management
Atorvastatin 80mg OD
(Identify and address of risk factors, eg smocking and alcohol)
What does of statin should be given if patient has CKD, eGFR <60
20mg Atorvastatin
If i non-HDL reduction of >40% has not been reached in 3 months, what to do?
Add Ezetimibe 10mg
If non-HDL is still over 4mmol/L despite max dose
Consider starting PCSK9i
