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34 Cards in this Set
- Front
- Back
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What two types of drugs increase blood lipid levels?
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beta blockers and diuretics
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What causes primary hyperlipoproteinemia?
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idiopathic or genetic
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What causes secondary hyperlipoproteinemia?
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alcoholism, diabetes
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Hyperlipoproteinemia contributes to the pathogenesis of what two conditions?
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atherosclerosis and CAD
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Chylomicrons are rich in?
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triglyceride
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Which lipoproteins carry TAG from the liver to adipose tissue?
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VLDLs
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Which lipoproteins carry cholesterol from the liver to the tissues?
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LDLs
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Which lipoproteins collect cholesterol from the tissues and transport it back into the liver?
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HDLs
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What time of day does the synthesis of cholesterol take place?
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at night
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What is the exogenous pathway for cholesterol synthesis?
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dietary fat in the gut is taken up and converted to chylomicrons which are then acted on by LPL and converted into chylomicron remnants that are taken up by the liver; once in the liver these become cholesterol and bile acids which enter enterohepatic circulation
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What is the endogenous pathway for lipid formation?
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occurs in the liver; VLDL acted on by LPL and converted into IDL and then LDL; LDL is taken up by LDL receptors on hepatocyte and converted into cholesterol
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What two drugs are bile acid sequestrants?
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cholestyramine and colestipol
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What is the MOA for bile acid sequestrants?
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interrupts enterohepatic circulation of bile salts
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What occurs in the body with the use of bile acid sequestrants?
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compensatory increase in VLDLs
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What can occur with increased TAGs?
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pancreatitis
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What are the 2 adverse effects that can occur with bile acid sequestrants?
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constipation, deficiency of fat soluble vitamins
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The HMG CoA reductase inhibitors are also known as?
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statins
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What class of hyperlipoproteinemia drugs are most efficacious and well tolerated?
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statins
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What is the MOA of the statin drugs?
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competitively inhibit HMG CoA reductase enzyme which is the rate limiting step in cholesterol synthesis; can also increase # of LDL receptors
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What is the main side effect seen with lovastatin and simvastatin?
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crosses BBB and causes sleep disturbances
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What is one benefit of Atorvastatin?
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can be taken at any time of day because longer acting
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What are the 2 major adverse effects of statin drugs?
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hepatotoxicity and myopathy
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Is the myopathy that can be experienced with statins irreversible?
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only in the early stages; if pt not removed from drug eary on then myopathy can deveop into rhambomyosarcoma and cause kideny damage due to free myoglobin in the blood
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What 2 drugs are fibric acid derivatives?
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fenofibrate and gemfibrozil
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What is the MOA for fibric acid derivatives?
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PPAR alpha agonist involved in the regulation of carbohydrate and lipid metabolism; get increased activity of LPL which decreases TAGs
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What is the main adverse effect of gemfibrozil?
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myopathy
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What is the MOA for nicotinic acid?
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increases HDL cholesterol
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What are the 3 adverse effects seen with nicotinic acid?
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flushing and itching, liver dysfunction, and hyperglycemia
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Why do you get flushing and itching with nicotinic acid?
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prostaglandin release
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What is the MOA for ezetimibe?
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decreases cholesterol absorption at the brush border of the SI
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What is vytorin a combination of?
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ezetimibe (decreases absorption) and simvastatin (decreases synthesis)
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Type III hyperlipoproteinemia can be tx by?
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gemfibrozil
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Type IIa and IIb hyperlipoproteinemia can be tx by?
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statins
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Type IV and V hyperlipoproteinemia can be tx by?
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niacin and fibrates
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