Triglycerides lecture Flashcards
If triglycerides go over 500 then they start to effect the __________
liver
Cheese, _________ fat foods,meats,simple carbs can cause hypertriglyceridemia
saturated fat
500-<1000mg/dL: hepatic steatosis- fatty liver
≥1000 mg/dL: ____________
pancreatitis
How to treat hypertriglyceridemia non-pharmacological recommendation please?
Implement very _______diet, avoid refined carb and ____________,
increase consumption of ____________
low-fat diet
alcohol
omega-3 fatty acids
Causes of hypertriglyceridemia drugs (_________, beta-blockers, corticosteroids), low _________, T2D (type 2 diabetes),
CKD(chronic kidney disease), genetics (familial hypercholeterolemia), _______abuse, uncontrolled diabetes
estrogen
low thyroid
alcohol abuse
uncontrolled diabetes
What do we do for hypertriglyceridemia?
First, assess risk.
If risk score ≥7.5% and TRIG ≥500mg/dl but <1000mg/dL
Treat with _______and lifestyle.
If TRIG >1000mg/dL, can consider adding a _______to avoid pancreatitis
statin
fibrate
EPA/DHA Fish Oil
Rx: Lovaza 1 gram (EPA and DHA)
ADR: ________taste, GI, increase risk of bleed
may be preferred for TRIG >500mg/dL and <1000mg/dL
OTC: 200-400mg EPA with DHA (not as effective as Rx)
DHA can increase LDL
bad taste
EPA might have more cardiovascular protection but DHA is more effective for triglycerides
Omega-3-acid ethyl esters (Lovaza)
GI symptoms (nausea, _________, burping, _____________ pain),
Side effects: Bleed, afib, flutter (will be reversed when pt is off medication)
bad taste, abdominal pain
Gemfibrozil (Lopid) causes dyspepsia :(
Fenofibrate (Tricor,Lofibra-micronized) causes dyspepsia and increased liver enzymes
Fibric acid derivatives
Gemfibrozil: Do not use with ___________ due to myalgia risk
Interaction: increased effect of _________
Avoid in patients with CrCl <30 mL/min
do not use with statins with gemfibrozil
increased effect of warfarin
Fenofibrate: Better fibrate to use with a statin (But better to avoid if possible)
Avoid in patients with CrCl <30 mL/min
Nicotinic acid (niacin,Niaspan) side effects are liver enzymes, _________
Nausea/ Vomiting/Diarrhea=ulcer
gout
Niacin is effective at getting triglycerides down
Gemfibrozil and fenofibrate both interact with warfarin
