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24 Cards in this Set
- Front
- Back
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Lipid:
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Fat-like compound characterized by relative insolubility in water.
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Cholesterol:
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Type of lipid required for normal life functions
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Triglyceride (TG):
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Molecule composed of fatty acids and glycerol
Used as one of the major energy substrates |
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Lipoprotein:
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Particle consisting of a protein conjugated with lipids to form a carrier for transport of nonpolar lipids in the plasma.
Includes: Chylomicrons, VLDL, IDL, LDL, and HDL |
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Chylomicron:
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Transports exogenous (dietary) TG and cholesterol
Absent in blood after 12-14 hour fast |
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Lipoprotein
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Composed of LDL and a protein called apo(a)
Linked to heart disease Lp(a) levels are almost entirely inherited Hard to remove from the blood stream |
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Intermediate density lipoprotein (IDL):
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Derived from VLDL breakdown in capillaries, converted into LDL or removed from blood by liver
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Low density lipoprotein (LDL):
“Bad cholesterol” |
Lipoprotein responsible for atherosclerosis
-Excess LDL sticks to blood vessel walls and penetrates the walls Contributes to the formation of hard, fatty deposits or plaques |
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High density lipoprotein (HDL):
“Good Cholesterol” |
reverse transport of cholesterol from peripheral cells to the liver and aids metabolism of TG-rich lipoproteins
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Model for plasma TG and Cholesterol transport
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Exogenous pathway
These cells convert the cholesterol and TGs into chylomicrons then transported into the blood through the lymphatic system |
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Model for plasma TG and Cholesterol transport exogenous
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Lipoprotein lipase converts chylomicrons into remnant particles taken up by the liver the cholesterol-rich remnants are transformed into bile salts or redistributed to other body tissues
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Etiology of Hyperlipidemia
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Primary: genetic predisposition
Secondary: lifestyle, diet, disease states, medications |
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Bile Acid Binding Resins
Drugs: |
Cholestyramine (Questran, LoCholest, Prevalite)
Colestipol (Colestid) Colesevelam (Welchol |
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Bile Acid Binding Resins
Mechanism of Action: |
Bind bile acids in the intestinal lumen to form a nonabsorbable complex that is excreted in the feces
Liver compensates by converting more cholesterol to bile acids, causing a drop in cholesterol concentration |
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Bile Acid Binding Resins
effectson lipids |
LDL: decrease 15%-30%
HDL: increase 3%-5% TG: usually not affected, may increase |
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Bile Acid Binding Resins
Cautions/Contraindications: |
severe GI dysfunction/constipation
Biliary obstruction Hyperchloremic acidosis Single therapy for elevated TGs Absolute: TG > 500 mg/dl Relative: TG > 200 mg/dl Pregnancy and lactation |
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Bile Acid Binding Resins
Drug Interactions: |
May bind to other (anionic) drugs decreasing their absorption
Administer drugs 1-2 hours before or 4 hours after resin dose |
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Bile Acid Binding Resins
adverse effects |
Frequent gi symptoms:
Constipation, Bloating Epigastric fullness Flatulence, Nausea Prevention:Maintain adequate fluid intake and high fiber diet |
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Nicotinic Acid
Drugs: |
Nicobid®, Niacor®, Nicolar®, Niaspan®
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Nicotinic Acid
MOA |
Inhibits secretion of VLDL from the liver causing decrease in production of LDL
Inhibits lipolysis in adipose tissue Increases lipoprotein lipase activity Decreases esterification of TG in the liver |
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Nicotinic Acid
Effect on Lipids: |
LDL: decrease 10%-25%
HDL: increase 15%-35% TG: decrease 30%-50% |
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Nicotinic Acid
Cautions/Contraindications: |
Relative:
Severe hypotension Gout or significant hyperuricemia Diabetes mellitus History of peptic ulcer disease Absolute: Liver disease Active peptic ulcer disease |
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Nicotinic Acid
Drug Interactions: |
Insulin or oral hypoglycemic
Bile acid binding resins Statins, Myopathy Rhabdomyolysis |
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nicotinic acid
Adverse Effects: |
Flushing, Pruritis, Tingling
Headache, Urticaria aspirin or ibuprofen 30 minutes before AM dose Take with food Avoid heavy alcohol use and hot drinks |
