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PMP 201 Patient-Centred Learning > Lipid Homeostasis and antihyperlipidemic drugs > Flashcards

Lipid Homeostasis and antihyperlipidemic drugs Flashcards

1
Q

Lipids

A
  • Free Fatty acids, cholesterol and triglycerides that are synthesized within cells or from dietary fat
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2
Q

Cholesterol

A
  • Fluidity, cell growth and viability
  • precursor for vit D and bile salts
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3
Q

Triglycerides

A
  • Synthesized in the liver ad supplies energy and fuel to muscles
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4
Q

Pathway 1 : Dietary cholesterol enter

A
  • Enters in intestine from diet enters micellar membrane
  • Absorbed and transported to liver where it is mixed with hepatic cholestero
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5
Q

Pathway 2: How is cholesterol absorbed

A
  • From micelles into intestinal wall via protein channel (NPC 1L1) on electrolyte plasma membran
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6
Q

Pathway 3: Bile emulsification

A
  • Emulsify dietary lipids and facilitate absorption
  • Bile salts are the recycled via hepatic portal vein
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7
Q

ATP-binding removal of cholesterol

A
  • Immediately pumped out of body into the intestinal lumen
  • Heterodimeric transporter protein ABCG5/G
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8
Q

De novo synthesis

A
  • Synthesis in the liver 70-80%
  • Synthesis in small intestine 10%
  • HMG-CoA reductase which a highly membrane bound enzyme catalyze rate limit step in sterol and isoprenoid biosynthesis to produce Cholesterol
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9
Q

Lipid homeostasis

A
  • Cholesterol and triglyceride are insoluble in water so transported by carrier protein (lipoprotein)
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10
Q

Lipoprotein

A
  • Central core containing cholesterol ester (hydrophobic)
  • Triglyceride surrounded by free cholesterol phospholipids
  • Apolipoproteins facilitate lipoprotein formation
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11
Q

Function of Apolipoprotein

A
  • Serve a structural role
  • Ligand for lipoprotein receptor
  • Guiding the formation of lipoprotein
    serving as activator inhibitor involved in metabolism of lipoproteins
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12
Q

HDL

A
  • Anti-atherogenic size low density is high
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13
Q

LDL

A
  • Pro-atherogenic as it has a larger size and lower density
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14
Q

Chylomicrons

A
  • Large triglyceride-rich particles made by intestine - transport triglycerides and cholesterol to peripheral tissue & liver
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15
Q

Chylomicron remants

A
  • Removal of triglycerides from chylomicron by peripheral tissue small remnants
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16
Q

Very LDL

A
  • Produced in the liver and are triglyceride rich
17
Q

Intermediate density lipoproteins

A
  • Removal of triglycerides from VLD & adipose forming IDL which is enriched in cholesterol
18
Q

Low density lipoprotein formation and function

A
  • LDL is produced from VLDL and IDL
  • LDL is enriched with cholesterol
  • LDL carry most of cholesterol in circulation
  • Contain one APO B-100 particle
  • High level of APOB-100 causes risk of atherosclerosis
19
Q

Hypertriglyceridemia

A
  • Abundance of LDL and low levels of HDL, obesity and type 2 diabetes
20
Q

sLDL

A
  • Decrease affinity for LDL receptor therefore large concentration of LDL in blood
  • Easily enter arterial wall binding and causing arterial legions
  • sLDL more susceptible to oxidation so more macrophages are recruited therefore inflammation occurs
21
Q

High-density lipoproteins

A
  • Contain cholesterol and phospholipids
  • Apo A-1 is core protein multiple
  • High levels of Apo A-1 linked to decreased risk of atherosclerosis
22
Q

Functions of HDL

A
  • Stimulates macrophage cholesterol efflux collecting removes no plate development
  • Anti-inflammatory
  • Decreases LDL oxidation
  • Anti-apoptotic
23
Q

Most important role of HDL

A
  • Reverse cholesterol transport cholesterol transport making HDL ani-atherogenic
24
Q

Lipid homeostasis

A
  • Exogenous lipoprotein pathway incorporates dietary lipids to chylomicrons in intestine
  • Triglycerides carried in chylomicrons are metabolized in adipose tissue by lipoprotein lipase
    Release of fatty acids which are metabolized by muscle and adipose leave chylomicron remnants
25
Q

In the liver lipid homeostasis

A
  • Formation of VLDL in the liver
  • Triglycerides carried in VLDL are metabolized in muscle by lipoprotein lipase release free fatty acids and IDL
  • IDL is metabolized into LDL and is taken up by LDL receptor in tissues such as liver
26
Q

Reverse cholesterol transport

A
  • Excess cholesterol from cells is bought back to the liver by HDL
  • Formation of nascent HDL in liver. Then acquire the cholesterol and phospholipids effluxed from cell by ABCA1forming mature HDL
27
Q

Pathophysiology of atherosclerosis

A
  • Endothelial dysfunction
  • Formation of lipid layer or fatty streak within the intima
  • Migration of leukocytes and smooth muscles into the vessel wall
  • Foam cell formation
  • Degradation of extracellular matrix
28
Q

Factors that effect oxidized LDL

A
  • Stress, smoking, obesity and fat diet enhance conversion causing inflammation
  • Platelets recruit sit on endothelial layer
29
Q

Hyperlipidemia

A
  • Abnormally high levels of fat include cholesterol and triglycerides
30
Q

Lipid lowering

A
  • Cholesterol synthesis inhibition
  • Intestinal absorption
  • Lipoprotein lipase activity
  • HDL
31
Q

Cholesterol synthesis inhibition

A
  • Statin completely inhibits HMG-CoA reductase leading to reduced cholesterol
  • Compensation for cholesterol level the liver recruits more LDL for circulation
32
Q

Side effects of cholesterol synthesis inhibition

A
  • GI disturbances
  • Skeletal muscle myopathy
33
Q

Anion exchange resins

A
  • Cholestyramine and colestipol bind with bile salts and excreted in feces
  • Unpalatable, digestive problems, interfere with fat soluble nutrients and drug
34
Q

Lipoprotein Lipase inhibition

A
  • Fibrates elicit complex effects on circulating effects (fenofibrate)
  • First line for hypertriglyceridemia
  • Combine fibrate and statin greater effect
35
Q

Increase HDL level in circulation

A
  • Nicotinic acid receptor antagonist reduces circulation VLDL and LDL and increase HDL
  • Side effect tachycardia, itching, nausea and vomiting
36
Q

Coronary circulation

A
  • Two tiny arteries leaving out of aorta
  • Profuse blood into myocardium
  • Handle high pressure
  • Thickening of internal surfaces of arteries cause ischemia

PMP 201 Patient-Centred Learning (51 decks)

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