Treating Hyperlipidaemia Flashcards
What are the major classes of drugs used to treat hyperlipidaemia?
Statins Nicotinic acid Omega 3 fatty acids Fibrates Cholesterol lipase inhibitors
What is the mechanism of action of statins?
Inhibition of HMG co A reductase
How do we decide if someone needs to start statin therapy?
Calculate their Q risk score- if their 10 year risk of CVD event is 10% or more then start on 20mg atorvastatin
If someone has had a cardiovascular event what treatment should be given regarding lipid lowering drugs?
Start on 80mg atorvastatin
What is the aim in terms of cholesterol reduction from statin therapy?
Aiming for 40% reduction in non HDL cholesterol.
What are the side effects of statin therapy?
GI upset
Headaches, dizziness
LFT disturbance, hepatitis
MYALGIA- rarely rhabdomyolysis.
What is the PK of atoravastatin?
Well absorbed from gut. Undergoes FP metabolism to make active derivatives. Has very long half life.
What is the mechanism of action of nicotinic acid in treating hyperlipidaemia?
Apo B degradation is enhanced, triglyceride synthesis is inhibited, secretion of VLDL and LDL is reduced.
What is the mechanism of action of fibrates?
Increased production on lipoprotein lipase
Some reduction in LDL
Reduction in triglyceride production
What is an example of a fibrate?
Gemfibrozil
What are the pharmacokinetics of fibrates?
Absorbed well from gut, highly protein bound in plasmaa
What are the side effects of fibrates?
Rash/pruritis
Gi upset
Dizziness, headache
What is the mechanism of action of cholesterol lipase inhibitors such as ezetimibe?
Acts at brush border of small intestine mucosa and inhibits cholesterol absorption
What are the pharmacokinetics of ezetimibe?
Rapidly but incompletely absorbed from gut
Metabolised in gut wall and liver
Long half life
Mainly excreted in faeces.
What are the side effects of ezetimibe?
Angioodoema
Headache
Diarrhoea
Abdominal pain
