Lipid lowering Flashcards
Name the 4 classes of lipid lowering drug
Statins, fibrates, nicotinic acid, anion exchange resins
Why is HDL good?
It brings cholesterol from tissues to liver
Name 4 statins
Simvastatin, pravastatin, fluvastatin, atorvastatin
How do statins work?
HMG-CoA reductase inhibitor, compensatory increase in LDL receptors clears LDL from the blood stream
What diseases do statins treat?
Prevention on MI and stroke, 1st line drug for hypercholesterolaemia (reduce progression of atherosclerosis)
What are the other beneficial effects of statins?
Decreased vascular inflammation and thrombosis, improved endothelial function and plaque stability and reduced prostate and colorectal cancer.
What are the side effects of statins?
Myalgia (flu like) <5%
Rhabodmyolysis (muscle breakdown leading to renal failure)
Name 3 fibrates
Clofibrate, fenofibrate, gemfibrozil
How do fibrates work?
Fibrates decrease the synthesis of VLDL and activates Lipoprotein lipase in the tissue capillary (forming HDL and TGs for muscle/adipose) so TGs in plasma falls.
What are fibrates used to treat?
Mainly hyper-TG (to reduce pancreatitis)
Gemifbrozil can be used for coronary artery disease
What are the side effects of fibrates?
Flu, nausea, vomiting, diarrhoea, gall stones
How does nicotinic acid work?
Reduces VLDL release from liver, lower plasma TGs and LDL
What is the alternative to nicotinic acid?
Acipimox (better tolerates, less effective)
Side effects of nicotinic acid
flushing, itching, dizziness, palpitations, hyperglycaemia, gout
How do anion exchange resins work?
They bind to bile acids to stop them being reabsorbed back into liver, so liver increases LDL receptors, which clears LDL from plasma
