Lipid lowering drugs Flashcards
Classes of lipid lowering drugs
Statins
Nicotinic acid
Fibrates
Cholesterol lipase inhibitors
MoA of statins
Inhibit HMGCoA reductase so decrease production of cholesterol
Also have secondary benefits - anti inflammatory, lower thrombotic risk, reduce atherosclerotic plaques
Side effects of statins
Myalgia
Arthralgia
Raised LFTs
GI side effects
What worsens myalgia with statins
If taken with gemfibrozil, cyclosporin or erythromycin
MoA of fibric acid
Peroxisome proliferator activated receptor agonist
Increase lipoprotein lipase synthesis (so decrease triglycerides)
Contraindications for fibric acids
Hepatic, gall bladder or renal dysfunction
Indications for fibric acid
Hypertriglyceridaemia
Hyperlipidaemia which is unresponsive to nicotinic acid
Side effects of fibric acid
GI side effects
Gall stones
Myositis
MoA of nicotinic acid
Inhibits lipoprotein synthesis
Contraindications of nicotinic acid
Liver disease
Unexplained raised LFTs
Peptic ulcer disease
Side effects of nicotinic acid
Hepatotoxic Decreased insulin sensitivity (hyperglycaemia) Pruritis Headache GI side effects
MoA of ezetimibe
Inhibits intestinal absorption of cholesterol
I.e a lipase inhibitor
How does ezetimibe remain at site of action
Circulates enterohepatically (local side effects)
Side effects of ezetimibe
Diarrhoea
Abdominal pain
Risk of giving statins with fibric acid
Rhabdomyolysis
Myopathy
