Pharm: Lipid Lower Agents

Question 1

A large decrease in LDL cholesterol, a small increase in HDL cholesterol, and a small decrease in triglycerides

Answer 1

Statins:
competitive inhibitors of HMG CoA reductase. This inhibition causes an increase in LDL receptor expression in the liver and subsequent breakdown of LDL.
Hepatotoxicity (increase LFTs), myopathy (esp. when used with fibrates or niacin)

Question 2

A moderate decrease in LDL cholesterol with little to no effect on HDL or triglycerides

Answer 2

ezetimibe:
blocks cholesterol and phytosterol (a plant sterol) absorption in the small intestine. Less cholesterol is thus delivered to and stored in the liver, and clearance of cholesterol from blood is increased.

Question 3

A moderate decrease in LDL cholesterol, a slight increase in HDL cholesterol, and a slight increase in triglycerides

Answer 3

bile acid resins:
cholestyramine and colestipol.
They act by binding to bile acids and steroids in the small intestine. These bile acids, bound to the bile acid resin, are lost through the digestive tract, instead of being absorbed.

Question 4

A small decrease in LDL cholesterol, a small increase in HDL cholesterol, and a large decrease in triglycerides

Answer 4

Gemfibrozil is a fibric acid derivative that acts on peroxisome proliferator-activated receptor-α protein to increase the activity of lipoprotein lipase. As a result, lipoprotein lipase facilitates enhanced clearance of triglycerides