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15 Cards in this Set
- Front
- Back
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Hyperlipidemia |
71 million >200 mg/dL
High is >240, >200 borderline Males higher than females, except for whites |
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Statin Benefit Groups |
Clinical althersclerotic vascular disease
LDL >190 mg/dL
DM w LDL>70
LDL >70 and estimated 10 year >/=7.5% |
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Primary Prevention |
>/=21 yo c LDL >/=190
statin max + adj to reduce LDL 50%
>21 c LDL>190 and TG >500 evaluate for secondary causes
40-75 yo c LDL 70-189: risk 7.5% or more - moderate statin risk 5-7.5% - consider statin, weigh risks/benefits
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Secondary Prevention |
<76 c ASCVD - High-intensity statin therapy
<76 c ASCVD - moderate if can't tolerate high
>75 with ASCVD - continue statin if tolerating
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High Intensity |
Atorvastatin 40-80
Rosuvastatin 20-40 |
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Moderate Intensity |
Atorvastatin 10-20
Rosuvastatin 5-10
Simvastatin 20-40
Pravastatin 40- 80
Fluvastatin |
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Pravastatin, Fluvastatin, Rosuvastain, , Pitavastatin |
Less interactions, esp Pravastatin
R has higher SE profile
DO NOT GIVE TO Preg/Lac |
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Lovastatin, Simvastatin, Atorvastatin |
HMG-COa inhibitors: block enzyme necessary for cholesterol synthesis in the liver -> increasing LDL clearance from blood
Effect: Increase LDL, TG and increase HDL -improve endothelial function -moderate inflammation -maintain plaque stability/prevent thrombus
Given in evening, cholesterol is produced between MN and 3 am, except Lovastatin needs to be with food
DO NOT GIVE for Preg/lac, liver disease, ETOH. seizures, severe infection
Monitoring: baseline, 6 & 12 weeks LFTs, greater than 3x basline dc, return to baseline try different statin, possibly baseline CK, >10 normal, cut in 1/2 or dc
SE Myopathy -> Rhabdomyolysis, Hepatoxicity
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Niacin |
Lower all bad, increases all good
Indicated for patients at risk for pancreatitis
Start low, give 3 divided dose daily, titrate 1-2 weeks; or LA 1 QD, titrate monthly; max 6g/d
Avoid c gout, renal failure, liver disease
Monitor lipids, LTFs, uric acid, INR(if applicable), check q3m
SE: Flushing, pruritis - asa 325 before dose offsets, HA, GI, arrthymias |
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Bile Acid Resins |
Decrease LDL, increase TG
CI: LDL elevation only
Monitor: LDL/TG baseline, LFT, INR, 1-3 month intervals
DO NOT take dry, take with largest meal of day, no carbonated beverages. ABX, thyroid hormones and fat soluble vitamins must be taken separately. Avoid children/pregnant, biliary obstruction, HX constipation
SE: GI |
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Gemfibrozil, Fenofibrate |
Decrease TG and increase HDL(feno slight effect on LDL) - Gem best for increasing HDL
Rapid action 2-5 days, reduced dose with peptic ulcer disease, warfarin: Gem 30 minutes before meals, feno with meals
Monitoring: LFTs, PT
Do NOT hepatic, renal, biliary cirrhosis, very cautious with statins
SE: GI, myopathy |
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Exetimibe |
Cholesterol Absorption Inhibitor in small intestine
Adjunct with statin therapy
SE: fatique, back/joint pain, GI sinisitus |
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Hypertriglyeridemia |
150-199 Borderline high 200+ High 500+ becomes primary target
gemfib or nicotinic acid are best Tx |
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Metabolic Syndrome |
Abdominal obesity
low HDL levels
High TG (>150)
Elevated BP
Fasting BG >110
Statin recommended, could use gemfibrozil |
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hi |
score |
