Lipid Lowering Drugs

Question 1

What types of lipids are there?

Answer 1

• cholesterol
• triglycerides
• fatty acids
• phospholipids

Question 2

LDL, HDL

Answer 2

want low LDL and high HDL

Question 3

why do we want to lower cholesterol?

Answer 3

-reduction in vascular events

• decrease cvs mortality, cvs morbitiy
• clear relationship in lower cholesterol and reducing cardiovascular events

Question 4

Who do we treat with statins

Answer 4

• people with angina, MI, cva,
• diabetics
• CVS risk is over 30% over 10 years

Question 5

How low do we lower LDL

Answer 5

• we dont know?

- also do life style changes, drugs

Question 6

Simvastatin

Answer 6

statin - lower TC, LDL and increase HDL and decrease triglyertide
-blocks acetyl choline going to cholesterol

adverse effects - skeletal muscle aches and pains
-also interacts with other drugs - verapamil, amiodarone, diltiazem, erythromycin - p450 cytochrome

Question 7

Bexafibrate

Answer 7

• decreases triglycerides, increase HDL
• Should try all of this first before going on this - diet, exercise, weight loss, decrease alcohol, increase DM control , but if still have high triglycerides then can use this
• combined therapy with statins - resistant hyperchlesterolaemia
• decrease VLDL production
• gi upset, muscle problems

Question 8

Ezetimbe

Answer 8

• blocks transporter in intestinal mucosa
• decraese cholesteorl absorption
• lower intrahepatocyte choelsterol

side efects - abdominal pain, diahorrhea

-normally used if person on a statin, but want to improve ldl reduction further

Question 9

Nicotinic acid

Answer 9

• not very commonly used
• only if want to bring down triglycerides
• dry skin, gi intolerance, flushing