Lecture 19- Lipid-lowering Drugs Flashcards
Coronary heart disease (CHD)
- leading cause of death globally
Characterised by;
- elevated levels of low-density lipoprotein cholesterol (LDL-C) + triglycerides
- low levels of high-density lipoprotein cholesterol (HDL-C)
^ build-up of fatty deposits (atheroma) on the walls of coronary arteries
Accumulation of atheroma= narrowing of coronary arteries -> restricting blood flow to the heart-atherosclerosis
Risk factors;
- smoking, hypertension, obesity, diabetes, lack of exercise, diet, inherited defect in lipoprotein metabolism + combo of genetic and lifestyle factors
Lifestyle changes + drug treatment= 30-40% reduction in mortality
Treatment strategies in hyperlipidaemia
Drug treatment should be based on assessment of atherosclerotic CVD (ascvd)
Therapeutic lifestyle changes; diet, exercise, weight loss- may help reduce cholesterol levels
Antihyperlipidaemic drugs
Statins; HMG CoA reductase inhibitors
- atorvastatin, fluvastatin, lovastatin + simvastatin
-Niacin
-Fibrates; Fenofibrate
-Bile acid sequestrants;
*Cholestyramine
*Colestipol
Statins
HMG CoA= converted to cholesterol by HMG CoA reductase
Statins inhibit the HMG CoA reductase enzyme -> decreased conc of cholesterol within the cell
^ promotes uptake of LDL-C from blood -> increased synthesis of LDL receptors
^ effective in lowering plasma cholesterol levels in all types of hyperlipidaemias
Side effects; elevation of liver enzymes-monitor liver function prior to initiation of treatment
^ caution in pt with liver dysfunction
Statins= may inc effect of warfarin. Evaluate INR when initiating statin treatment/ changing the dose
