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17 Cards in this Set
- Front
- Back
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what do statins inhibit?
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HMG-CoA reductase, which is responsible for the synthesis of cholesterol
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how do statins work?
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by inhibiting HMG-CoA reductase, they inhibit cholesterol synthesis, this increases expression of LDL-R and increases removal of LDL-C from circulation
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what are the major risk factors for CHD?
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smoking, male >45, female >55, current/prior CHD, diabetes, dyslipidema, fam hist, obesity
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target LDL: <70, 100, 130, 160.... respective risk factors`
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multiple; ongoing CHD or stroke; 2+ risk factors; 0-1 risk factors
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which statins have a side group that mimics HMG-CoA substrate?
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pravastatin, atorvastatin
MIMIC jew, PRAY the TORRA |
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which statins have a lactone ring side group that must be activated within the liver?
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lovastatin, simavastatin
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what is the most frequent SE of statins?
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myopathy, flu-like muscle pain in arms and legs
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what is a rare but very very serious SE of statins?
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rhabdomyolysis; from rapid muscle breakdown.... may shut down kidneys
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which statins have really long half-lives?
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atorvastatin and rosuvastatin (20 hours..... greater efficacy [max response])
TORRA and ROSES have STAYING POWER |
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what is the effect of statins on triglycerides and why??
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substantially lowered...
TGs circulate as part of VLDLs VLDLs have B100 receptor (like LDL) upregulation of LDL receptor may also stimulate endocytosis of VLDL particles |
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what are the "other potential benefits" of statin therapy?
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greater endothial cell function, greater stability of plaques, use in cancer treatment (reduce farnesyl-PP and geranylgeranyl-PP---> pro-onco genes)!!!!!
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what can you use for pts with high TGs + high LDL-C?? and what might be induced?
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use statins + either
a) fibrates b) niacin may induce myopathy |
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what effects does niacin have on lipid profile? what do we know that it does?
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GREAT ONES!! everything (ldl, hdl, TGs all benefit)
we know it reduces liver secretion of VLDL |
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what are the fibrates?
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gemfibrozil, ciprofibrate, fenofibrtae
("FIB") |
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what effects do fibrates have on lipid profile?
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lowers TG, raises HDL-C, modest effects on LDL-C
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how do fibrates work?
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activates PPARalpha (steroid receptor) --> which lowers liver release of VLDL
increased risk of rhabdomylysis |
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VYTORIN
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simavastatin + ezetimide
inhibits uptake of dietary cholesterol, however no data on plaque formation |
