Anti-Hyperlipidemic Agents

Front 1

Cholestyramine
class/MOA?
uses?
adverse?
contra?

Back 1

-Bile acid binding resin; binds bile acids in lumen by exchanging Cl- (resins NOT absorbed from lumen)
-all hyperlipidemias (of high LDL), itching (cholestasis), diarrhea from excess fecal bile acids, pseudomembranous colitis
-~50% constipation, dyspepsia, hyperTG, metabolic acidosis, dec fat soluble vit absorption
-biliary obstruction, severe hyperTG, any preexisting coagulopathy (Vit K), constipations...

Front 2

Lovastatin
class/MOA?
uses?
adverse?
contra?

Back 2

-HMG-CoA reductase inhibitor; stops rate limiting step of CE synthesis
-(very low oral bioavailability), hyperlipidemias involving high CE or LDL, atherosclerosis, primary CAD prevention, stroke prevention
-GI (could inc serum aminotransferase), hepatotoxicity, motor system (could inc creatine phosphokinase),
-Preggos, liver dz, renal perfusion problems, use with niacin, fibrates or CYP450 inhibitors could inc myopathy

Front 3

Niacin
class/MOA?
uses?
contra?

Back 3

-Vit B3 (water soluble); inhibits lipolysis, most effective at inc HDL, reduces fibrinogen, stimulates PG and histamine release, inhibits uric acid secretion, decreased glu tolerance
-all hyperlipidemias with high VLDL, LDL, and low HDL
-peptic ulcer dz, liver dz, DM, gout, hyperuricemia, bleeding, surgery, coagulopathy

Front 4

Gemfibrozil
class/MOA?
uses?
adverse?
contra?

Back 4

-Fibric acid derivatives (fibrates); activates nuclear transcription PPARa which inc LPL synth and enhances removal of plamsa VLDL
-Type III hyperlipoproteinemia, hyperTG
-dyspepsia, dysgeusia, cholelithiasis, myopathy/rhabdomyolysis (with statins)
-gallbladder dz, biliary cirrhosis, hepatic dz

Front 5

Ezetimibe
class/MOA?
uses?
adverse?
contra?

Back 5

-Intestinal sterol absorption inhibitor; localizes at brush border of SI and selectively inhibits
-hyperlipidemias, mostly combined with sterols (can dec LDL ~25%)
-myalgia, diarrhea, hypersensitivity
-severe liver dz (inc 1/2 life)