Hyperlipidemia Flashcards
Statins: Drugs
Atorvastatin
Rosuvastatin
Statins: Mechanism
Inhibit HMG-CoA reductase
Most effective LDL-cholesterol lowering drugs
Reduces LDL-cholesterol
- 25-63% reduction
- Most effective when given in evenings
- Cholesterol levels returns to pretreatment levels if statin is stopped
Elevates HDL, reduces TG
- Wine can also increase HDL, other antioxidants, exercise
Pleotropic activity
- Improves plaque stability
- Could help slow down the progression of alzheimers
- Reduces inflammation
- Reduces coagulation
Statins: adverse effects
Myopathy and Rhabdomyolysis - Elevation in creatinine kinase - Cerivastatin withdrawal Statin induced myalgia - Corrected by resolution of vitamin D deficiency Hepatotoxicity - Elevated serum transaminase
Bile-acid sequestrants: Drug
Colesevelam
Colesevelam: Mechanism
Cholesterol binding
Anion exchange resin that binds bile acids in the intestine and promotes its fecal excretion
Decreased bile acid reabsorption causes hepatocytes to upregulate bile acid synthesis from cholesterol
Also upregulates LDL- receptors on hepatocytes
Colesevelam: Use
With a statin
Hyperlipidemia in young
Colesevelam: Adverse effects
Constipation, flatulence, bloating, cramping
Inhibitors of cholesterol absorption: Drug
Exetimibe
Exetimibe: Action
Inhibits intestinal absorption of cholesterol
Exetimibe: Absorption
Rapid absorption in intestine
Nicotinic acid: Drug
Niacin (Vitamin B3, Niaspan, Niacor, Slo-Niacin
Niacin: Action
Reduces hepatic synthesis of TG and VLDL by inhibiting mobilization of free fatty acids from peripheral tissues
Lowers VLDL, pancreatitis
Increases serum HDL
Niacin: Uses
To lower VLDL, pancreatitis
To lower LDL
Niacin: Adverse effects
Flushing, pruritus
- 325 mg aspirin 30 min before each dose
Hyperglycemia, hyperuricemia, liver toxicity
