Drugs for Lipid Disorders, Heart Failure, and Diuresis

Comprehensive vocabulary flashcards covering cardiovascular pharmacology, including anti-lipemic agents, heart failure medications, and various classes of diuretics based on the lecture.

Cholesterol

A lipid used to produce steroids and hormones, build cell membranes, and build bile acids.

Triglycerides

An energy source consisting of fats from the diet or formed in the small intestine, with excess stored in adipose tissue.

Lipoproteins

Particles required for the transport of lipids; types include Chylomicron, HDL, LDL, and VLDL.

Exogenous Cholesterol

Dietary cholesterol that is absorbed in the intestines.

Endogenous Cholesterol

Cholesterol that is produced in the liver.

HMG-CoA Enzyme

An enzyme used by the liver in the production of cholesterol.

Hyperlipidemia

A condition characterized by elevated blood lipid levels, also referred to as Metabolic Syndrome.

Total Cholesterol Lab Value

$$<200\,mg/dL$$

LDL Lab Value

$<100\,mg/dL$ (optimal $<70\,mg/dL$)

HDL Lab Value

$$>40\,mg/dL$$

Triglycerides Lab Value

$$<150\,mg/dL$$

Atherosclerosis

The build-up of cholesterol and other debris on the arterial endothelium which gradually occludes the vessel and impairs contractility.

HMG-CoA Reductase Inhibitors

Also known as "Statins," these are first-line therapies for hyperlipidemia that work in the liver to increase hepatic LDL receptors.

Rhabdomyolysis

A serious side effect of Statins involving muscle breakdown; patients should report changes in urine color.

atorvastatin (Lipitor)

A high-intensity HMG-CoA Reductase Inhibitor used to lower LDL and triglycerides while mildly increasing HDL.

Fibric Acid Derivatives

Also called "Fibrates," these activate lipase enzyme to decrease triglyceride production and increase cholesterol secretion into bile acid.

gemfibrozil (Lopid)

A fibric acid derivative used for hypertriglyceridemia and mixed dyslipidemias; it can increase the risk of rhabdomyolysis when given with statins.

Bile Acid Sequestrants

Drugs that bind bile to prevent resorption of cholesterol in intestines; identified by the prefixes "cole" or "chole."

cholestyramine (Questran)

A bile acid sequestrant powder used for hyperlipidemia and loose bowel movements that must be diluted in $4-6\,mls$ of liquid to avoid choking.

Nicotinic Acid (Niacin)

Vitamin $B_3$; it inhibits LDL production and clearing while preventing the clearance of HDL.

ezetimibe (Zetia)

A selective cholesterol absorption inhibitor that inhibits cholesterol absorption in the small intestines, usually used as adjuvant therapy with statins.

evolocumab (Repatha)

A PCSK9 Inhibitor administered via SC injection that uses monoclonal antibodies to bind to the liver.

Omega-3 Fatty Acids

Substances like Fish or Krill oil used to lower triglycerides and increase HDL, though they may increase bleeding risk.

Heart Failure

An inability of the heart to fill and pump blood to meet the metabolic needs of the body, culminating in fluid overload and impaired perfusion.

Positive Inotrope

A drug mechanism that improves the pumping action of the heart.

Negative Chronotrope

A drug mechanism that slows the heart rate.

digoxin (Lanoxin)

A cardiac glycoside that interferes with the sodium-potassium adenosine triphosphatase pump and augments vagal tone.

Digoxin Therapeutic Level

$$0.5-2.0\,ng/mL$$

Digibind

The agent used to treat cardiac glycoside (digoxin) toxicity.

ivabridine

An HCN Blocker that slows heart rate by slowing conduction through the SA node without the systemic effects of Beta Blockers.

valsartan-sacubitril (Entresto)

An ARNI that prevents the breakdown of natriuretic peptides and inhibits RAAS to improve HF symptoms and reduce CV mortality risk.

acetazolomide

A Carbonic Anhydrase Inhibitor that inhibits sodium resorption at the proximal tubule and reduces aqueous humor in the eyes.

Loop Diuretics

Drugs such as furosemide that block sodium and water resorption in the Loop of Henle.

Ototoxicity

A side effect of loop diuretics characterized by tinnitus.

mannitol (Osmitrol)

An Osmotic Diuretic that increases osmotic pressure in glomerular filtrate to pull water into the nephron for diuresis.

spironolactone (Aldactone)

A potassium-sparing diuretic that competes with aldosterone to hold onto potassium while blocking sodium/water resorption in distal tubules.

Gynecomastia

A potential side effect associated with the use of potassium-sparing diuretics like spironolactone.

Thiazide Diuretics

Drugs like hydrochlorothiazide that prevent resorption of sodium, potassium, and chloride in the distal tubule; often first-line therapy for black patients with HTN.