Lipid Lowering

Question 1

Statins (HMG-CoA) Reductase Inhibitors

Answer 1

-Block the conversion of HMG-CoA to mevalonate, the rate limiting step in producing cholesterol in liver. This increases the number of LDL receptors available, thus enabling more binding of LDL by the liver rather than transmission to the bloodstream

Question 2

Contraindications of Statins?

Answer 2

• Pts. With hepatic disease or associated problems, those with chronic kidney or renal disease, pregnant and breastfeeding, those with hypersensitivity or intolerance issues, and aminotransferase elevations.
• Check for hypothyroidism!

Question 3

Statin Side-Effects

Answer 3

• Adverse Muscle events leading to myopathy
• Some GI and headache
• Potential proteinuria

Question 4

Complimentary to statins, acts at border of small intestine and decreases cholesterol to liver.

Answer 4

Cholesterol Absorption Inhibitors (Zetia)

Question 5

Decrease cholesterol absorption through exogenous pathway, not absorbed from GI tract. Decreases overall return of cholesterol to liver by binding bile acids in Small Intestines.

Answer 5

Bile Acid Resins (Cholestyramine)

Question 6

Uncertain MOA, but appears to decrease VLDL synthesis in liver, inhibits lipolysis in adipose tissue and increases lipoprotein lipase activity. A naturally occurring B Vitamin.

Answer 6

Niacin

Question 7

Mainly affect triglyceride and HDL levels–>Stimulate lipoprotein lipase.

Answer 7

Fibric Acid Derivatives