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19 Cards in this Set
- Front
- Back
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statins effect on lipid profile
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best decrease in ldl cholesterol (18-55%)
hdl varied increase( inc when already high) TG- (-) 7-30% (not best) |
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statins MOA
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inhibit hmg cAO reductase
hmgcoa to mevalonic acid RLS in chol synth increase ldl-r (actual mech for dec in blood cholesterol) with additional cardioprotective effects (-PL agg, antiinfl,stabile plaques(even reverse)(atorvastatin most potent=lipitor) |
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lipitor=
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atorvastatin ( most potent)
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Statins SE
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hepatotoxic--(transaminase *3 =abn)usually only if pre-existing dys.
pregnancy XXXXXXXXXXX****** MYOPATHY (this is the big one)monitor creatinine present with dark urine Rhabdomyolisis (additive with gemfirozil and niacin) grapefruit juice(cyp 450 inh) |
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Statins contraindications
and drug interactions |
absolute----preg, active liver disease,
Relative-cyp450 inh (grapefruit juice) |
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bile acid sequestrants
named |
cholestyramine,colestipol,
colesevalam |
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BA sequ.....mOA
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+ charge bind (-) bile
dec neg feedback = inc prod cholest cont BAs increased LDL-R BUT increased TGs******** |
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CHolestyramine
effect on lipid profile |
(questra)a bile acid sequestrant
LDL- (-) 15-30% (pretty good) hdl + 3-5% TG = or INCREASE***** |
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CHolestyramine
SEs |
hyper TGs
dec VIT ABS bloat, constipation binds heavily to acidic drugc (dig,warf,thiaz,vit k) CIs- high TGs, DM |
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Ezetimibe
Moa |
Chol abs (-)
No effect on FS vitamins prodrug DIARRHEA......abd pain (INDUCED STEATORHEA) |
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Vytorin
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ezetimibe + simvastatin
additive |
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Ezetimibe
effect on lipid profile |
minimal change for the best accross the board
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nicotinic acid
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inhibits TG syntheisis inhibits lipase to leave less free FA available for VLDL synthesis----results in decreased ldl levels
BEST For increased HDL levels |
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nicotinic acid effect on lipid profile
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(-) LDL 5-25%
HDL + 15-35%********* TGs (-) 20-50% (VERY GOOD) |
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Niacin SE
CIs |
FLUSHING(dose limiting) pretreat with aspirin)
Preg C Hyperuricemia Hepatotoxic Hyperglyc in DM CIs Absolute-liver dis, gout rel- DM (dec free FA>dec liver TG syn> dec VLDL> increased Insulin resistance,PUD (inc acid prod) |
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stimulate lipoprotein lipase
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the fibrates
Gemfibrozil, Clofibrate, fenofibrate |
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Gemfibrozil
Moa |
unclear----activates lipoprotein lipase
works on periphery decreased VLDL synth incr clearance> dec ldl |
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Fibrates
SE CONTRA |
GI distress
rash BM depress Myositis (usually with statin combo) gallstones CIs severe liver/renal disease |
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Fibrates
effect on lipid prophile |
rarely first line therapy
ldl moderate HDL 10-20% ( 2nd best) TGS up to 50% (very good) |
