cholesterol med functions

how do statins work

inhibits HMG CoA reductase —> blocks cholesterol synthesis

what is the high intensity statin therapy

atorvastatin (40-80), rosuvastatin (20-40)

what are contraindications for statin therapy

active liver disease, high alcohol consumption, pregnancy

what do we need to consider with statin therapy

monitor when taking other cytochrome P450 meds, check baseline LFTs, check baseline CK in elderly and renal impairment

what are side effects of statins

GI disturbances, elevated LFTs and ALT, elevated CPK/myopathy

what do brush border inhibitors doe

inhibits intestinal absorption of cholesterol

T/F: Brush Border enzymes can be used by itself or with statins in pts with high cholesterol to reduce LDLs and total cholesterol

trueT

do we need to monitor LFTs with brush border enzymes?

no

how do PCSK9 inhibitors work

preserves LDL receptors (which increases LDL removal)

what are indications for PCSK9 use

primary hyperlipidemia, ASCVD, genetic hyperlipidemia

what are side effects of PCSK9

injection site reaction, URI sx, back pain

what does bempoic acid (nexletol) do

ATP-citrate lyase inhibitor that lowers ONLY LDL

can bempoic acid affect triglycerides or HDL

no

what do bile acid sequesterants do

forms complex and interrupts circulation of bile acids, and promote sterol excretion

whats the indication for bile acid sequesterant use

hypercholesterolemia caused by elevated LDL

what are contraindications for bile acid sequesterants

biliary obstruction, triglycerides >400 (can increase them), hx of bowel obstruction

what are side effects of bile acid sequesterants

GI distress, constipation, decreased drug absorption (separate by 2 hours)

what do nicotinic (niacin) acids do

reduce triglycerides and increase HDLw

what are contraindications of nicotinic acids

chronic liver disease, gout

what are side effects of nicotinic acids

flushing, hyperglycemia, hyperuricemia, hepatotoxicty

what do fibric acids do

reduction in triglycerides and HDL; esp if triglycerides >500

what might fibric acids cause

pancreatitis

what are side effects of fibric acids

abnonrmal LFTs, elevated CPK/myopathy, dyspepsia/abd pain