Antilipemic Drugs and Lipoprotein Metabolism

Vocabulary flashcards covering antilipemic drug classes, mechanism of action, lipid components, and clinical nursing considerations.

Triglycerides

Main energy-storage lipids stored in adipose tissue.

Cholesterol

A lipid used by the body to synthesize steroid hormones, cell membranes, and bile acids.

Chylomicrons

Lipoproteins composed mostly of triglycerides that transport dietary/exogenous fats from the intestines to the liver.

VLDL

Very Low-Density Lipoprotein that carries endogenous lipids to peripheral tissues and subsequently becomes IDL and LDL.

IDL

Intermediate-Density Lipoprotein formed as VLDL loses triglycerides, serving as an intermediate product between VLDL and LDL.

LDL

Low-Density Lipoprotein composed mostly of cholesterol that carries cholesterol to tissues and the liver; known as "bad cholesterol" because elevated levels promote atherosclerosis risk.

HDL

High-Density Lipoprotein that removes and recycles cholesterol back toward the liver; known as "good cholesterol" and is cardioprotective.

Foam cells

Macrophages in subendothelial tissue that have absorbed cholesterol, representing the initial characteristic lesion and fatty streak of atherosclerosis.

Metabolic Syndrome

A collection of risk factors including waist circumference $>40\,\text{in}$ in men or $>35\,\text{in}$ in women, triglycerides $\ge 150\,\text{mg/dL}$, HDL $<40\,\text{mg/dL}$ in men or $<50\,\text{mg/dL}$ in women, BP $\ge 130/85\,\text{mm Hg}$, and fasting glucose $>100\,\text{mg/dL}$.

Statins (HMG-CoA Reductase Inhibitors)

First-line class of antilipemic drugs that inhibit HMG-CoA reductase to reduce hepatic cholesterol production, leading to increased liver LDL receptors and decreased circulating LDL by up to $50\%$.

Atorvastatin

A statin medication used to lower cholesterol and LDL, whose primary safety concern and test point is myopathy and rhabdomyolysis.

Simvastatin

A statin drug administered at bedtime that lowers LDL and triglycerides and has major drug interactions, requiring restricted grapefruit juice intake.

Ezetimibe

A cholesterol absorption inhibitor that blocks cholesterol absorption in the small intestine; must be administered $2\,\text{hours}$ before or $4\,\text{hours}$ after bile acid sequestrants.

Bile Acid Sequestrants

Class of antilipemic agents (e.g., cholestyramine, colestipol) that bind bile acids in the intestine to prevent reabsorption, causing the liver to consume cholesterol to produce more bile acids.

Cholestyramine

A bile acid sequestrant that lowers LDL and treats pruritus from biliary obstruction; must be administered $1\,\text{hour}$ before or $4\text{--}6\,\text{hours}$ after other medications.

Fibrates

Antilipemic drug class (e.g., gemfibrozil, fenofibrate) that activates lipoprotein lipase to primarily lower triglycerides and VLDL while raising HDL.

Gemfibrozil

A fibrate medication used to lower triglycerides and VLDL, which carries a severe risk of rhabdomyolysis when combined with statins.

Niacin (Vitamin B3)

A vitamin B3 lipid-lowering agent that decreases triglycerides and LDL while increasing HDL, with cutaneous flushing being its primary adverse effect.

PCSK9 Inhibitors

Subcutaneously administered antilipemic agents (e.g., alirocumab, evolocumab) that inhibit PCSK9 and reduce LDL cholesterol by up to ~$70\%$.

Bempedoic Acid

An ATP-citrate lyase inhibitor that decreases cholesterol synthesis and LDL levels, with hyperuricemia and gout as major adverse effects.

Evinacumab

An ANGPTL3 inhibitor administered via IV infusion for homozygous familial hypercholesterolemia to lower LDL and triglyceride levels.

Rhabdomyolysis

A severe muscle injury toxicity associated with statin therapy and statin-fibrate interactions, characterized by muscle pain, dark urine, and potential acute renal failure.