Lipid Lowering

Question 1

HMG coA reductase inhibitors
Lovastatin
Pravastatin

Answer 1

LDL: ⬇️⬇️⬇️
HDL⬆️
TG⬇️

Mechanism
⬇️mortality in CAD Patients

Adverse:
hepatotoxicity
LFT⬆️
Myopathy (especially when used with niacin or fibrate)

Question 2

Bile acid resin
Cholestyramine
Colestipol
Colesevelam

Answer 2

LDL ⬇️⬇️
HDL⬆️
TG⬆️

Mechanism: prevent intestinal reabsorption of bile acid&raquo_space; liver use chl to make more

Adverse: GI upset, ⬇️absorption of other drugs and fat soluble vitamines

Question 3

Ezetimibe

Answer 3

LDL ⬇️⬇️
HDL⬆️
TG⬇️

Mechanism prevent chl absorption

Adverse: LFT⬆️, diarrhea

Question 4

Fibrate

Gemfibrosil
Bezafibrate
Fenofibrate

Answer 4

LDL ⬇️
HDL ⬆️
TG ⬇️⬇️⬇️

Mechanism/ upregulate LPL: ⬆️TG clearance
Induce HDL synthesis

Adverse: myopathy (⬆️risk with statin), chl gall stone (inhibition of chl hydroxylase)

Question 5

Niacin B3

Answer 5

LDL ⬇️⬇️
HDL⬆️⬆️
TG⬇️

Mechanism inhibits lipolysis in adipose tissue reduce hepatic VLDL synthesis

Adverse: red, flushed face, ⬇️ with nsaid, hyperglycemia
Hyperuricemia

Question 6

PCSK9
Alirocumab
Evolocumab

Answer 6

LDL ⬇️⬇️⬇️
HDL⬆️
TG⬇️

Mechanism inhibit degradation of LDL RECEPTOR
⬆️LD REMOVE FROME BLOOD

Adverse: myalgia, delirium, dementia, neurocognitove effect

Question 7

Fish oil and marine omega 3 fatty acid

Answer 7

LDL ⬆️
HDL ⬆️
TG⬇️

Mechanism
⬇️fatty acid delivery to liver and ⬇️activity of TH-synthetizing enzyme

Adverse effect
Nausea , fish like taste