Hyperlipidemia Treatment

Question 1

Atorvastatin, Lovastatin, and Simvastatin

Answer 1

Lipophilic HMG COA Reductase inhibitors.

Indication:

MOA: Structurally similar to HMG COA competitively binds to decreased the syntheses of Melvonic acid and cholesterol

Effects: inhibits the manufacture of cholesterol… lowers cholesterol and serum TG levels Slight increase in HDL

Decrease atherosclerosis, MI and Decrease mortality in pts w/ CAD

Short half life, HA, Blurred vision, dizziness, abd pain, constipation and nausea

Dont give to prego/lactation women

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Question 2

Statin drug interactions

Answer 2

Question 3

Gemfibrozil and Fenofibrate

Answer 3

Fibrates

Indications: HyperTG, and helpful w/ Type III(elevated IDL) and also help w/ chylomicroenmia

MOA: activates liprotien lipase(LPL)
AND vibrates are agonist of peroxisomes proliferator activated receptors(PPAR-A) which leads to elevated HDL

Effectes: decreased VLDL and increase HDL

Adverse: myopathy and hepatic dysfunction

Question 4

Niacin

Answer 4

Indication: Low HDL, Elevated VLDL, and LDL

MOA: Decreased catabolism of APOAI and reduces VLDL secretion from Liver

Effects: Increase HDL and decreased LipoproteinA, LDL and TG

Can help w/ elevated TG associated w/ pancreatitis

Adverse: gastric irritation, flushing, may reduce glucose intolerance

Question 5

Colesevelam, Colestipol, and cholestryamine

Answer 5

Bile Acid Resin

Indication:

MOA: Interrupts the enterohepatic circulation of bile acid.. Bile acids(-‘ve)bile acid resins(+’ve) prevent recycle.. Forces liver to use cholesterol to make additional bile acids…

Advers: not as effective as statins in lowering LDL. so use in combo w/ statin or niacin

Can cause constipation/bloating and inferrers w/ the absorption of some drugs

Question 6

Bile acid interactions

Answer 6

Question 7

Ezetimibe

Answer 7

Cholesterol absorption inhibitors

Indications: elevated LDL and phyosterolemia

MOA: Breaks sterol transporter NCP1L1 in the intestine(brush border)

Effects: inhibits the reabsorb od cholesterol and increased cholesterol excreted in fecal.

Adverse: May cause hepatic toxicity

Question 8

PCSK9

Answer 8

PSCK9 inhibitors

Indications:

MOA: inhibit psck9 which degrades LDL receptors on hepatocytes