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Pharm Unit 4 by Hans Kim > drugs for lipid lowering agents > Flashcards

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why is HDL anti-atherogenic?

1. reverse cholesterol transport
2. protects against endothelial dysfunction
3. inhibits oxidative stress


what are the 5 classes of hypolipidemic agents?

1. nicotinic acid (niacin)
2. fibric acid derivatives (fibrates)
3. bile acid sequestrants (resins)
4. HMG-CoA reductase inhibitors (statins)
5. Ezetimibe (a new class of lipid lowering agent)


what does niacin do?

1. raises HDL
2. lowers TGs
3. lowers LDL


side effects of niacin?

1. hepatoxicity
2. hyperglycemia
3. hyperuricemia
4. flushing
5. pruritis
6. dyspepsia
7. rashes


what does fibric acid derivatives do?

1. reduction in VLDL
2. variable (but small) effects on LDL
3. 10% increase in HDL


what is the mech of fibrates?

effects are mediated by binding to PPARa


how does gemfibrozil work?

activation of lipoprotein lipase


what are bile acid sequestrants (resins)?

1. anion-exchange resins that bind bile acids in the intestines
2. are not absorbed, bound bile acids secreted in stool
3. decreases LDL but increases TGs
4. safe, but interferes with absorption of fat-soluble vitamines


what are statins?

1. most effective, best-tolerated
2. reduce LDL, VLDL
3. increase HDL


what are the adverse effects of statins?

1. hepatic dysfunction
2. myopathy


what are the two possible beneficial effects of statins?

1. counteract osteoporosis
2. cardioprotective


what is the new class of lipid lowering agent?



what is the mech of ezetimibe?

inhibits both dietary and biliary cholesterol absorption in the intestine by blocking a sterol transporter on the enterocyte --> thus, it reduces the amount of cholesterol delivered to the liver


what are the effects of ezetimibe?

1. lowers LDL (synergistic with statins)
2. once a day pill
3. few side effects


both ezetimibe and simvastatin lowered LDL

by 52% at the starting dose