Drugs for cholesterol

Question 1

lowers serum cholesterol by blocking cholesterol absorption at the brush border or enterocytes
-targets Niemann-Pick C1-like protein (transport protein for clathrin-mediated endocytosis)

Answer 1

Ezetimibe

Question 2

resins that bind bile acids and similar steroids in the intestine, inhibiting their absorption
-cause modest reduction in LDL
-no effect on HDL or triglycerides
Adverse: bloating, constipation, absorption of vitamins (vitamin K and folate) as well as drugs (warfarin, pravastatin, fluvastatin) are impaired

Answer 2

cholestyramine
colestipol
colesevelam

Question 3

reduces LDL cholesterol, triglycerides, and VLDL while increasing HDL
-decreases fibrinogen and increases tissue plasminogen activator
Adverse: cutaneous flush -> give aspirin or other NSAID to reduce this side effect

Answer 3

niacin

Question 4

PPAR-alpha agonists
-enhances triglyceride clearance
Adverse: myopathy, hepatic dysfunction, cholestasis

Answer 4

gemfibrozil

fenofibrate

Question 5

inhibit HMG-CoA reductase

Adverse: myopathy, hepatic dysfunction, teratogen

Answer 5

atorvastatin
simvastatin
rosuvastatin