Hyperlipidemia Flashcards Preview

SS- Cardio > Hyperlipidemia > Flashcards

Flashcards in Hyperlipidemia Deck (40):
1

VLDL

liver
delivers hepatic TGs to peripheral tissue

2

LDL

formed from IDL
delivers hepatic cholesterol to peripheral tissues

3

chylomicrons

intestine
delivers dietary TGs to peripheral tissue and cholesterol to the liver

4

Lp(a)

LDL + protein (a) that resembles plasminogen
found in atherosclerosis and CAD (inhibits thrombolysis)

5

desired LDL level

160

6

desired HDL level

men: > 40
women: >50
high: >60

7

desired TG level

200

8

LDL receptor

in liver and peripheral tissues
bind ApoB

9

apolipoproteins

hydrophobic core with cholesteryl esters and TGs surrounded by unesterfied cholesterol, phospholipids and apoproteins

10

CETP

found on vascular surface
transfers cholesterol esters to other lipoprotein particles

11

LPL

degrades TGs circulating in chylomicrons and VLDLs

12

ApoC-II

cofactor for LPL

13

ApoC-III

inhibits lipoportein binding to receptors

14

PPAR-a

nuclear transcription factor
upregulates LPL and HDL

15

ApoB-48

intestine
found in chylomicrons

16

ApoB-100

liver
found in VLDL, IDL, LDL
ligand for LDL receptors

17

primary chylomicronemia

apoC-II or LPL defect
elevated chylomicrons, VLDL
pancreatitis

18

familial hypertriglyceridemia

LPL defect (defective VLDL metabolism)
elevated VLDL, TG
pancreatitis

19

familial dysbetalipoproteinemia

defective metabolism of VLDL, chylomicrons, ApoE defect
elevated IDL, VLDL, cholesterol, TG
atherosclerosis

20

familal combined hyperlipidemia

increased ApoB
elevated VLDL, LDL
premature atherosclerosis

21

familial hypercholesterolemia

LDL receptor, ApoB defet
elevated LDL
premature atherosclerosis

22

desirable total cholesterol

240

23

secondary hyperlipidemia causes: hypertriglyceridemia

DM, alcohol, severe nephrosis, estrogen, uremia, corticosteroids, myxedema, hypopituitarism, acromegaly, immunoglobulin-lipoprotein complex disorders, lipodystrophy, protease inhibitors

24

secondary hyperlipidemia causes: hypercholesterolemia

hypothyroidism, early nephrosis, resolving lipemia, immunoglobulin-lipoprotein complex disorders, anorexia, cholestasis, hypopituitarism, corticosteroids

25

dietary management of hyperlipidemia

limit calories from fat and cholesterol
eat complex carbs and fiber
weight reduction, calorie restriction and alcohol restriction

26

dietary factors that influence hyperlipidemia

increased TGs: excess calories, alcohol, total fat
increased LDL: cholesterol, saturated, and trans fat
increased VLDL: sucrose and fructose

27

statins

competitive and reversible HMG-CoA reductase inhibitors and upregulate LDL receptors (promote ER to Golgi transport and cleavage of SREBP)
strongest effect on LDL
UGT1A1 responsible for biotransformation of all statins
reduce CHD risk
AE: rhabdomyolysis (creatinine and kidney failure), teratogen, hepatic, GI distress, sleep disturbance/memory loss

28

bile acid resins

bind bile acids and prevent reabsorption
AE: GI, bad taste, hypertriglyceridemia, prevents absorption of other drugs and fat soluble vitamins

29

ezetimibe

prevents absorption of dietary cholesterol

30

niacin

inhibits release of FFA from adipocytes, decrease TG syn., decrease VLDL, increase transfer of cholesterol from macrophage to HDL, and enhances LPL to convert VLDL to LDL
decrease LDL and TG
reduces Lp (a) and increases HDL
reduces VLDL synthesis
AE: flushing (less for ER), hepatic, GI, hyperucemia, insulin resistance, myositis, eyes (conjunctivitis, cystoid macular edema, retinal detachment), and skin (dry, pruritus, ichthyosis, acanthuses nigricans)

31

lovastatin

metabolized by CYP3A4
intermediate potency and efficacy

32

simvastatin

metabolized by CYP3A4 intermediate potency and efficacy

33

pravastatin

metabolized by sulfating, oxidation and glucoronidation
low potency, low efficacy

34

atorvastatin

metabolized by CYP3A4 (and beta oxidation and glucoronidation)
long T1/2
high potency, high efficacy

35

rosuvastatin

metabolized by CYP2C9 (and glucoronidation)
long T1/2
high potency, high efficacy

36

fluvastatin

metabolized by CYP2C9

37

fibrates

bind PPARalpha nuclear receptor: upregulates LPL and HDL
AE: gallstones, myopathy, increased liver enzymes, reflux, diarrhea, possible teratogen

38

gemfibrozil

metabolized by glucoronidation (UGT1A1)
reduces statin metabolism UGT1A1 responsible for biotransformation of all statins

39

fenofibrate

active metabolite: fenofibiric acid
CI: renal disease

40

N-3 fatty acids

decrease TG, BP, platelet
anti-arrhythmic
reduce CHD
sources: fatty fish, fish oils, walnuts, flaxseed, rapeseed, soybean, canola oil