15 -drugs for hyperlipidemia

a. niacin

1. Only hypolipidemic vitamin

   a. niacin

   b. Thiamine

   c. Riboflavin

   d. Folic acid

a. Colestipol

2. An example of bile acid sequestrant

   a. Colestipol

   b. Atorvastatin

   c. Ezetimibe

   d. Niacin

a. Simvastatin

3. HMG coA reductase inhibitors

   a. Simvastatin

   b. Cholestyramine

   c. Fenofibrate

   d. Ezetimibe

a. Ezetimibe

4. A drug that inhibits the absorption of dietary cholesterol

   a. Ezetimibe

   b. Niacin

   c. Colesevelam

   d. Cerivastatin

b. LDL

5. Bad cholesterol

   a. HDL

   b. LDL

   c. VLDL

   d. chylomicron

• high LDL, low HDL

• increases the risk of atherosclerosis (build-up of fats, cholesterol and other substances in the artery)

Problems with Hyperlipidemia

Decrease LDL, Increase HDL

Goal of therapy for Hyperlipidemia

• Chylomicron

• VLDL

• LDL

• HDL

Lipoproteins:

Chylomicron

transport dietary lipids from the intestines to adipose tissue and liver

VLDL

delivers TG to adipose tissue

LDL

transports Cholesterol to peripheral tissues for incorporation into cell membranes, sterols, and steroids

BAD cholesterol

LDL is known as:

GOOD cholesterol

HDL is known as:

HDL

This lipoprotein acquires cholesterol from tissues

atherosclerosis

High LDL can cause what disease?

hypercholesteremia

High cholesterol can cause what disease?

pancreatitis

High VLDL can cause what disease?

hypertriglycerimia

High TG/TAG can cause what disease?

• STATINS

• BILE ACID-BINDING RESINS

• EZETIMIBE

• NIACIN (NICOTINIC ACID)

• FIBRIC ACID DERIVATIVES

HYPOLIPIDEMIC AGENTS

Statins

• HMG-CoA Reductase Inhibitors

• Tx hypercholesterolemia (lowers blood cholesterol)

• Fluvastatin, Lovastatin, Pravastatin, Pitavastatin, Atorvastatin, Rosuvastatin

Example of Statins:

Atorvastatin, Rosuvastatin

statins that have long half-life so they can given any time

GIT Upset (Constipation, Diarrhea), Rhabdomyolysis, Hepatitis (rare)

Statins A/E:

Bile Acid-Binding Resins

• moderately effective drugs for hypercholesterolemia ONLY

• MOA: increase fecal excretion of bile acid

Cholestyramine, Colestipol, Colesevelam

Bile Acid-Binding Resins drugs:

Constipation, fecal impaction

Bile Acid-Binding Resins drugs s/e:

Ezetimibe

• unique drug that inhibits the absorption of dietary cholesterol

• used alone or in combination with statins for hypercholesterolemia

headache, myalgia

Ezetimibe A/E:

Niacin

• only hypolipidemic vitamin

• MOA: inhibits formation & secretion of VLDL

• Use: hypertriglyceridemia

Vitamin B3

Niacin drugs:

Niacin Flush, Hepatitis, Hyperglycemia, Hyperuricemia

Niacin drugs’ A/E:

Fibric Acid Derivatives

• MOA: (+) PPAR-α  activation of LDL (catalyzes the removal of TG from VLDL) → low VLDL

• Effects: Low VLDL (highest), Low LDLC, High HDL-C

Clofibrate, Gemfibrozil, Fenofibrate

Fibric Acid Derivatives’ drugs:

GI problem , blood cell deficiencies (rare)

Fibric Acid Derivatives drugs’ A/E: