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30 Cards in this Set
- Front
- Back
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Decrease Bile Reab.
Drugs 3 |
Cholestyramine
Colestipol Colesevelam |
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Cholestyramine
Colestipol Colesevelam Mech |
Quart ammonium not absorbed
binds to bile acids and does not let them be reab. liver must make more bile INC of LDL receptors DEC LDL by 15-25% |
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Cholestyramine
Colestipol Colesevelam Uses |
Type IIa and IIb hypercholesterolemia
ineffective in patients who can't make LDL receptor |
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Cholestyramine
Colestipol Colesevelam Compliance |
Low b.c sand like substance
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Cholestyramine
Colestipol Colesevelam Mech - Downstream effects |
HMG CoA Red. not inhibited, so makes more cholesterol in liver
INC in liver syn of TGs and VLDLs |
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Cholestyramine
Colestipol Colesevelam Side E |
GI Stuff
Inc hepatic VLDL secretion Nausea, constipation, Diarrhea |
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Cholestyramine
Colestipol Colesevelam Drug interactions |
interferes with absorption of acidic drugs (any lipid soluble substance)
digitalis warfarin phenobarbital Vit A,D,E,K |
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Colesevelam
Features |
new drug
fewer interactions same results |
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Lower LDL Agents
Lovastatin Mech |
comp inhib of HMG-CoA reductase,
blocks production of mevalonate, precursor to cholesterol |
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Lower LDL Agents
Lovastatin Features |
Dec intracellular levels of cholesterol
LDL receptors made INC endocytosis and catabolism of LDL INC HDL |
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Lower LDL Agents
Lovastatin Other Features of inhib pathway early |
dec. smooth m. proliferation
inc bone formation in women (by inhib osteoclasts) anti inflammatory |
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Lower LDL Agents
Lovastatin Use |
hypercholesterolemia
20-40% dec. |
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Lower LDL Agents
Lovastatin Side E |
Hepatoxicity (check liver fxn)
Myopathy - many types, low % affected (INC risk with 2 drugs) not in preggers |
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STATINS
Simvastatin (Zocor) |
single daily dosing
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STATINS
Pravastatin |
inhib of HMG
inhib hepatic syn of VLDL |
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STATINS
Atorvastatin (Lipitor) |
single day dosing
does not inc HDL as much |
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STATINS
Rosuvastain and pitavastatin |
super statins
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Lowers LDL Agents
Ezetimibe (Zetia) Mech |
interferes with cholesterol absorption
secreted in bile used with other drugs |
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Lowers LDL Agents
Niacin, Nicotinic Acid Mech |
inhibi lipolysis in adipose tissues, dec fFAs, inhib cAMP
inhib liver syn of TGs and CETP |
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Lowers LDL Agents
Niacin, Nicotinic Acid Results |
Dec plasma VLDL 20-80%
LDL 10-40% Inc HDL 10-20% |
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Lowers LDL Agents
Niacin, Nicotinic Acid Use |
Reducing circulating lipoproteins
hypercholesterolemia mixed hyperlipidemia hypertriglyceridemia 3-5 wk maximal effect |
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Lowers LDL Agents
Niacin, Nicotinic Acid Side E 5 |
flushign and pruritis - feel like jumping out of skin
aspirin helps GI - peptic ulcer liver dysfxn impaired glucose tolerance inc plasma uric acid |
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Lower Triglycerides
Niacin Fibrates (DRUGS 2) |
Clofibrate
Fenofibrate |
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Lower Triglycerides
Clofibrate Fenofibrate Mech |
Binds to peroxisomal proliferation activating receptor (PPAR alpha)
INC LPL INC catabolsim of CM and VLDL, inhib syn and release of triglycerides DEC VLDL release; LDL; triglycerides INC Apo A1 and A2; leads to INC in HDL |
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Lower Triglycerides
Clofibrate Fenofibrate Use |
Type III familial dysdetalipoproteinemia
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Lower Triglycerides
Clofibrate Fenofibrate Side E |
flu like symptoms
CAD, does not appear good, 2nd or 3rd line choice |
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Lower Triglycerides
Clofibrate Fenofibrate Drug Interactions |
displaces warfarin from albumen
directly inhib platelet aggregation |
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Lower Triglycerides
Gemfibrozil (Lopid) Mech |
Activated PPARalpha
INC LPL, thus catab of TGs and CMs DEC adipose tissue lipolysis DEC liver triglyceride syn INC Apo A1 and AII leads to INC HDL |
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Lower Triglycerides
Gemfibrozil (Lopid) Use |
Hypertriglyceridemia, Mixed Hyperlipidemia
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Lower Triglycerides
Gemfibrozil (Lopid) Side E |
GI
Rash, INC LPL INC LCAT |
