Hyperlipidemia Flashcards
What are the nine different classes used to treat hyperlipidemia?
1) HMG-CoA reductase inhibitors
2) Niacin
3) Fibric Acid derivatives
4) Bile Acid Sequestrants
5) Inhibitors of Intestinal Sterol Absorption
6) Omega-3 Polyunsaturated Fatty Acids
7) Antisense Olgonucleotides
8) Microsomal Triglyceride Transfer Protein Inhibitors
9) PCSKT9 Inhibitors
What drugs are considered HMG-CoA reductase inhibitors?
Statins
What drug is considered Niacin?
Nicotinic acid
What drugs are considered fibric acid derivatives?
Gemfibrozil, Fenofibrate, and Fenofibric acid
What drugs are considered bile acid sequestrants?
Colestipol, cholestryamine, and colesevelam
What drugs is an inhibitor of intestinal sterol absorption?
Ezetimibe
What drugs are considered omega-3 polyunsaturated fatty acids?
Vascepa, Lovaza, Enova
What drug is considered an antisense oligonucleotide?
Mipomersen
What drugs is considered a microsomal triglyceride transfer protein inhibitor?
Lomitapide
What drugs are considered PCSKT9 inhibitors?
alirocumab and evolocumab
What is the net effect of the HMG-CoA reductase inhibitors?
Most effective in lowering LDLs (30-35%)
Moderate decrease in triglycerides (10-30%)
Small increase in HDL
What is the mechanism of action of Statins?
Analog of HMG-CoA reductase which inhibits the HMG-CoA reductase enzyme. This inhibits the formation of cholesterol and causes an increase in the number of high-affinity LDL receptors to uptake LDL out of the plasma.
What are the toxicities associated with statins?
- Increase serum aminotransferase
- Increase in serum creatinine kinase
- Increase in glycosylated hemoglobin and fasting blood glucose
- Increased diabetes risk
- Myopathy and cognitive impairment
How do statins reduce the risk of cardiovascular disease?
- Improve endothelial function
- Reduce platelet aggregation
- Reduce oxidative stress
- Reduce C reactive proteins
- Reduce vascular inflammation
- Stabilize atherosclerotic lesions
