Pharm- Lipid lowering Flashcards
HMG co-A reductase inhibitors- MOA
HMG = precursor to cholesterol. Competitively inhibits cholesterol synthesis & depletes intracellular supply-> increasing uptake from blood.
HMG co-A reductase inhibitors - Indications
AKA- statins-First line tx for high LDL. Reduce CHD risks
- plaque stabilization, endothelial function, inhibit thrombus formation, anti-inflammatory
HMG co-A reductase inhibitors - AE
- Contraindicated in pregnancy, children, active liver disease
- Liver failure, myopathy
Nicotinic acid- Niacin- MOA
- Inhibits lipolysis of adipose tissue- lowering hepatic VLDL, LDL.
- Reduces catabolism of HDL
- Boosts plasminogen activation
Nicotinic acid- Niacin-Indications
Increases HDL and reduce LDL by 10-20%. Reduce MI risk.
Nicotinic acid- Niacin-AE
hepatotoxicity, hyperglycemia, cutaneous flush, pruritus, uricemia & gout
Contraindicated: liver & gout
Fibric Acid- gemfibrozil, clofibrate, fenofibrate- MOA
Increases rate of gene expression for proteins which increase expression of lipoprotein lipase and decreasing apolipoprotein
- Inhibit TG production, increase HDL
Fibric Acid- gemfibrozil, clofibrate, fenofibrate- Indications
hyper-triacylglycerolemias (hereditary)
- Mixed evidence that reduces risk of CHD
Fibric Acid- gemfibrozil, clofibrate, fenofibrate- AE
GI disturbances, lithiasis, myositis,
HMG co-A reductase inhibitor- Risk Factors
Advanced age, CKD, preoperative, alcohol, grapefruit juice, hypothyroid
Bile Acid Sequestering- MOA
Bind to bile acids preventing reuptake and increasing excretion in feces
Bile Acid Sequestering- Indication
Used in conjunction with statins to reduce cholesterol
Bile Acid Sequestering- AE
May elevate TG
-GI disturbance, impaired absorption of fat soluble vits. & medications
