Anti Lipid Flashcards
(43 cards)
_____ million Americans have elevated cholesterol. Dyslipidemias have been classified into 5 major subtypes. ____ causes half of all deaths in US. The incidence of CHD correlates with high levels of _____cholesterols and triacylglycerols and low levels of HDL cholesterol.
40; Coronary heart disease (CHD); LDL
What do the most common types of dyslipidemias involve
- elevated LDL (IIa) –> genetic component
- VLDL (IV)
- Both LDL and VLDL (IIb)
What are risk factors for CHD
- cigarette smoking
- hypertension
- obesity
- family history
what do lipid lowering therapies aim to do
- decrease carrier production
- increase degradation
- decrease absorption
- increase removal
when is the patient borderline for total high cholesterol levels
220-240
when is patient borderline for LDL cholesterol
130-160
when is patient borderline for HDL cholesterol
35-60; want it greater than 60
What are the lipid lowering therapeutics
- HMG CoA Reductase Inhibitors (Statins)
- Fibrates
- Niacin (Vitamin B3)
- Cholesterol Absorption Inhibitors
What is the suffix of HMG CoA reductase inhibitors
“-statin”
Red rice yeast contains _____
lovastatin
Which statin’s have adverse effects in the CNS
- Lovastatin
2. Simvastatin
What is the indication for Atorvastatin
- Dyslipidemia
2. CVD Prevention
What is the mechanism of action of Atorvastatin
- Competitively inhibits HMG-CoA reeducates which is responsible for an early, rate limiting step in cholesterol biosynthesis.
- Increases hepatic LDL receptors, enhancing catabolism.
What are common adverse effects of Atorvastatin
- nasopharyngitis
2. myalgia (muscle pain)
what are skeletal AE of atorvastatin
myopathy
what are hepatic AE of atorvastatin
- impaired function associated with elevated serum transaminase levels –> jaundice
what are CNS AE of atorvastatin
amnesia
what are ocular AE of atorvastin
- dipolopia
- ptosis
- pseudo - CME
- blurred vision
- elevated IOP
- IOP hemorrhage
- cataracts
What are drug interactions of atorvastatin
cyclosporine, erythromycin, azole antifungals cause myopathy exacerbation.
What are contraindications of atorvastatin
azole antifungals
What are the indication of fibrates
- hypertriglyceridemia
2. hypercholesterolemia
when are fibrates prescribed
with statins or to statin intolerant patients; its a second line therapy, unless problems are severe and PCP decides to put them on both.
what is the MOA of fenofibrate
- stimulates nuclear receptor PPAR which modulates transcription of insulin sensitive genes in liver, muscle and adipose tissue.
- enhances HDL production; inhibits triglyceride synthesis and stimulates catabolism of triglyceride rich lipoproteins.
There is also an integral relationship between PPAR receptor and_______management and lipid level regulations in the body.
diabetes
