Lipid lowering drugs Flashcards
Mechanism of action of statins
They are analogues of HMG-CoA (inhibit the reductase enzyme)
What drug class is contraindicated In pregnancy and lactating
Statins
What are the adverse effects of statins?
Elevation of transaminases
Myopathy (increased CK)
What statins are metabolized by  CYP3A4
simvastatin
Lovastatin
Atrovastatin
What statins are metabolized by CYP2C9 
Fluvastatin
Rosuvastatin
What drugs are in the fibrate class?
Gemfibrozil 💎
Feno(?)fibrate
Bizafibrate 🍕
What is the mechanism of action of fibrates
They ligandly activates PPAR-α and:
1 ↑lipoprotein lipase (LPL) synthesis
2 ↑Apo A1 and Apo A2 synthesis
3 ↓Apo C3 synthesis
What are the adverse effects of fibrates
Skin rash
G.I. disturbance
Arrhythmia
LFT derangements
Myopathy (increased with statins)
Reduction of white blood cells or hematocrit
What is the nicotinic acid mechanism of action?
1- ↓ VLDL synthesis by decreasing flux of fatty acids to the liver
2- inhibit VLDL secretion -> also LDL
3- ↑ VLDL clearance by lipoprotein lipase pathway
4- ↓ HDL catabolism
What are the adverse effect of nicotinic acid
Cutaneous vasodilatation - flushing
Pruritus,rashes, dry skin,acanthosis nigricans.
GIT
deranged LFT , rarely hepatotoxicity
Hyperuricemia (precipitation)
What are the bile acid resins drugs
Colestipol
cholestyramine
colesevelam
MoA of Bile acid-binding resins
They bind to bile acid
Increased loss of LDL with feces
Adverse effects of Bile acid-binding resins
Constipation bloating
Heart burn
diarrhea
Name of the Inhibitor of intestinal cholesterol absorption?
Ezetimibe
Ezetimibe moa?
Block NPC1L1
Block absorption and reabsorption of cholesterol 
