Medications for Hyperlipidemia

These flashcards cover essential medications and concepts related to hyperlipidemia, including different classes, mechanisms, adverse effects, and guidelines.

Statins

HMG-CoA reductase inhibitors that lower LDL cholesterol.

Bile acid-binding resins

Medications that bind bile acids, reducing LDL cholesterol.

Ezetimibe

A drug that inhibits absorption of cholesterol at the intestinal brush border.

Niacin

Vitamin B3 that lowers LDL and triglycerides while raising HDL.

Fibrates

Medications like Fenofibrate and Gemfibrozil that activate PPAR-α.

PCSK9 inhibitors

Monoclonal antibodies that lower LDL by preserving LDL receptors.

HMG-CoA reductase

Enzyme targeted by statins to decrease cholesterol synthesis.

Atorvastatin

A potent statin known for significant LDL-lowering effects.

Lovastatin

A prodrug statin that must be taken with an evening meal.

Simvastatin

A statin with a higher risk for myopathy at 80 mg dosage.

Short half-life

The duration for which a drug remains effective in the body.

Bioavailability

The degree to which a drug is absorbed into the systemic circulation.

Myopathy

Muscle pain or weakness resulting from statin use.

Rhabdomyolysis

A severe condition where muscle breakdown leads to renal failure.

Adverse effects of statins

Include GI upset, constipation, diarrhea, and myopathy.

Monitoring for statins

Include checking for muscle pain, weakness, and elevated CK levels.

Drug interactions with statins

Can occur with CYP3A4 substrates leading to increased levels.

Cholestyramine

A bile acid-binding resin used to lower cholesterol.

Colesevelam

A bile acid-binding resin available in tablet form.

Mechanism of bile acid-binding resins

They bind bile acids and increase LDL receptor activity in the liver.

Ezetimibe effectiveness

Decreases LDL cholesterol by 19-23%.

Niacin’s lipid effect

Lowers LDL and triglycerides while raising HDL levels.

Transaminases

Enzymes monitored for liver function that can be elevated with niacin.

Fibrates mechanism

Activate lipoprotein lipase to lower triglycerides and increase HDL.

Severe TG indication

Fibrates are indicated for triglyceride levels over 500 mg/dL.

Omega-3 Fatty Acids

Nutrients that lower triglycerides and reduce platelet aggregation.

Lovaza

Prescription omega-3 supplement that decreases triglyceride levels.

PCSK9 inhibitors

Alirocumab and Evolocumab, which lower LDL cholesterol by preserving receptors.

Bempedoic acid

An ACL inhibitor used for familial hypercholesterolemia.

Indications for statins

Used for lowering LDL and managing cardiovascular risks.

Lipid-lowering agents

Medications aimed at reducing lipid levels in patients.

Myalgia

Muscle aches without elevated creatine kinase levels.

Hepatitis

Liver inflammation that can result in elevated liver function tests.

Flushing effect of niacin

Warmth and tingling sensation that can occur with niacin use.

CYP450 metabolism

Refers to a group of enzymes that metabolize many drugs.

Short t½ taking schedule

Some statins need to be taken at bedtime due to their short half-life.

Adverse effects of fibrates

Include GI upset, cytopenias, and potential myopathy.

Anticoagulation effects

Statins can increase the effectiveness of warfarin.

Ideal fish oil ratio

The ratio of omega-3 to omega-6 fatty acids should be 4:1 or less.

Bile acids

Digestive acids that, when bound by resins, lower cholesterol.

Interactions with digoxin

Bile acid resins can bind to digoxin, reducing its effectiveness.

Combination therapy caution

Using statins with fibrates or niacin can increase myopathy risk.

HDL cholesterol

High-density lipoprotein known as 'good' cholesterol.

Triglycerides

Fats found in the blood that can contribute to heart disease.

Cholesterol absorption

The process inhibited by ezetimibe at the intestinal brush border.

Renal failure

A potential serious consequence of severe myopathy.

Hyperuricemia

Elevated uric acid levels, a potential side effect of bempedoic acid.

Creatine kinase (CK)

An enzyme measured to assess muscle damage in myopathy.

Indications for using ezetimibe

Administered alone or in combination with statins.

Long-term benefits of statins

Including reduced atherosclerosis and coronary heart disease mortality.

Intensities of statin therapy

Defined as high, moderate, or low based on LDL reduction goals.