Lipid Lowering Drugs Flashcards
How often should cholesterol screenings happen?
Every 5 years in adults >20
HDL levels
<40 mg/dL is low-undersireable
LDL levels
<100 mg/dL desireable
When should drug therapies start?
if therapeutic lifestyle changes don’t work after 6 months to a year
Statins- AKA
HMG-CoA reductase inhibitors
Statins
Most effective drugs for lowering LDL
Promote plaque stability
Reduce the risk of CV events
Statin mechanism
increases LDL receptors on hepatocytes, Which enables the liver to remove LDL from the blood.
Which statin should not be prescribed for asian pts?
Rosuvastatin (crestor)- builds up in Asian patients and may cause hepatotoxicity.
Adverse effects of statins
Rare:
Myopathy/rhabdomyolysis- creatine kinase levels should be checked in case of muscle aches
hepatotoxicity- pain, jaundice, N/V
Drug interactions of statins
Most other lipid-lowering drugs, except bile acid sequestrants
Drugs that inhibit CYP 3A4
Use in pregnancy
When should statins be taken in the day?
Evenings with the evening meal. Night is when cholesterol synthesis in the liver is highest.
Nicotinic acid (niacin)
Taken at dose 100x greater than you’d normally take. Lowers LDL and TG. Increases HDL levels more effectively than any other drug.
Adverse effects of niacin
Skin- flushing, itching (can pretreat with aspirin 30 minutes before taking the drug, or decreased with SR version of the drug)
GI
Hepatotoxicity
Hyperglycemia
Colesevelam
Bile-acid sequestrant Newest and best tolerated drug Lowers LDL by increasing LDL receptors on the hepatocytes, prevent reabsorption of cholesterol in the GI tract. Reduces glucose—useful in diabetic pts Monitor for hypoglycemia Primarily used as an adjunct to statins.
Gemfibrizol
Fibrate- best for lowering TG
Little or no effect on LDL.
