Lipid lowering drugs

Question 1

Statins e.g. Simvastatin, Atorvastatin: Mechanism of action

Answer 1

Competitively inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis decreeing LDL cholesterol concentration.

Question 2

Statins e.g. Simvastatin, Atorvastatin: Effects/ clinical use

Answer 2

Hypercholesterolemia
Atherosclerosis
Reduce mortality after MI
any C

Question 3

Statins e.g. Simvastatin, Atorvastatin: Contradindications

Answer 3

Avoid Grapefruit juice
hepatic impairment
hypothyroidism

Question 4

Statins e.g. Simvastatin, Atorvastatin: side effects

Answer 4

myalgia, Myopathy, Rhabdomyolysis - report unexplained muscle weakness promptly
NV

Question 5

Statins e.g. Simvastatin, Atorvastatin: Dose

Answer 5

10mg OD up to 80mg OD

Question 6

Fibrates e.g. fenofibrate: Mechanism of action

Answer 6

Activating  PPAR (peroxisome proliferator-activated receptors), induces the transcription of a number of genes that facilitate lipid metabolism.
Fibrates are structurally and pharmacologically related to the thiazolidinediones, a novel class of anti-diabetic drugs that also act on PPARs (more specifically PPARγ)

Question 7

Fibrates e.g. fenofibrate: Effects/ Clinical use

Answer 7

Decrease serum triglyceride

Hyperlipidemia in those cannot tolerate a statin

Question 8

Fibrates e.g. fenofibrate: Contraindications

Answer 8

Hypoalbuminemia, primary biliary cirrhosis, gall bladder disease, nephrotic syndrome, renal impairment

Question 9

Fibrates e.g. fenofibrate: Side effects

Answer 9

GI disturbances

Question 10

Fibrates e.g. fenofibrate: Dose

Answer 10

200mg