Prophylaxis of Atherosclerotic Cardiovascular Disease Flashcards
Atherosclerotic Cardiovascular Disease (ASCVD)
thicken of artery
angina 1st symptom
damage to vessels result in MI or stroke; related to increasing LDL
Cholesterol
component of all cell membranes and membranes of intracellular organelles; synthesis of the hormone, bile salts; from diet but mostly by LIVER (HMG-CoA reductase)
Lipoproteins
HDL
LDL
VLDL
HDL
high density
carry cholesterol
want high reduces the risk of ASCVD
LDL
mostly cholesterol
delivery of cholesterol
want low; a lot is a big risk for atherosclerosis
VLDL
triglycerides; deliver triglyceride; want low; if high risk of pancreatitis
Triglycerides
store unused calories and provide your body with energy;
eat more calories than you burn, particularly “easy” calories like carbohydrates and fats, you may have high triglycerides
ASCVD Risk Factors
Age, African American, HTN, smoking, low HDL, diabtets
Non-Pharmacologic Methods for Cholesterol Reduction (Therapeutic Lifestyle Changes)-FIRST LINE TX
Diet (reduce sat fat, cholesterol, trans fat; increase fiber)
exercise
weight control
smoking reduction
do with drugs
Antihyperlipidemics
only if lifestyle changes didnt work; Bile Acid Sequestrants Fibrates Nicotinic Acid HMG-CoA reductase inhibitors (Statins) (LDL will go back if not taken meds)
LDL-Lowering Drugs - Statins
lovastatin
atorvastatin
pravastatin
simvastatin
Inhibit the enzyme HMG CoA reductase cholesterol synthesis
reduce LDL increase HDL
lovastatin
atorvastatin
pravastatin
simvastatin
so statins are most effective when taken in the evening (usually with dinner); improved clinical outcome
side effects of statins
monitor liver (hepatoxicity) eye exams for cataracts MUSCLE ACHES watch for Rhabdo GI memory diabetes pregnancy category X
LDL-Lowering Drugs - Statins drug interactions
antibiotics, HIV meds, antifungals, and cardiac meds.
LDL-Lowering Drugs – Bile Acid Sequestrants
LDL binds with bile acids prevent absorption and promote excretion;
Cholestyramine
Colesevelam