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29 Cards in this Set
- Front
- Back
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CHD is positively associated with...
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high TC and elevated LDL
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High levels of HDL are associated with...
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decreased risk of heart disease
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Primary goal of antihyperlipidemic drugs
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Reduction of LDL
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Levels for drug treatment
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LDL > 160 with one other major risk factor (HTN, diabetes, smoking)
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Goal LDL level
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less than 130 mg/dl
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Primary treatment for hypertriaclyglycerolemia
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diet and exercise
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Drug therapy for hypertriaclyglycerolemia
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niacin and fibric acid derivatives
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Secondary benefit of statin drugs
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Triacylglycerol reduction
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Effects of HMG CoA Reductase inhibitors (STATINS)
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lower elevated LDL
Inhibits first enzymatic step of cholesterol synthesis Increases number of LDL receptors in the liver Decrease plasma cholesterols |
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Therapeutic uses of Statins
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effective in all types of hyperlipidemia
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Patients with what disease do not react well to statins?
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Homozygous for familial hypercholesterolemia
--> lack LDL receptors |
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Adverse effects of Statins
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Biochemicals abnormalities in liver function
Myopathy, rhabdo May increase warfarin levels |
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Lab tests that should be run with Statins
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Liver function
Serum transminase levels Plasma creatine kinase PTT |
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CI for Statins
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pregnancy and nursing mothers
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Most effective agent for increasing HDL
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Niacin
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Mechanism of Action for Niacin
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Inhibits lipolysis in adipose
Decrease in liver triacylglycerol synthesis Increases HDL |
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Adverse effects of Niacin
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Intense cutaneous flush with uncomfortable warmth
--> give ASA with niacin to decrease Pruritus Predisposition to hyperuricemia and gout |
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Fibrate drugs
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fenofibrate
gemfibrozil |
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Drug class that lowers serum triacylglyerols
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Fibrates
-fenofibrate -gemfibrozil |
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Adverse effects of fibrates
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Inc biliary cholesterol excretion
-gallstones Myositis -mm weakness, tenderness Myopathy/Rhabdo |
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Drug interactions with Fibrates
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Competes with coumarin for binding sites
Monitor prothrombin levels |
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CI for Fibrates
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Pts wtih severe hepatic and renal dysfunction
Pts with gallbladder disease |
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Significant LCL cholesterol-lowering effects with benefits less than statins
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Bile acid-binding resins
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Bile acid-binding resins--- Drugs
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cholestyramine
colestipol colesevelam bind with bile acicds and bile salts in small intestine |
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Mechanism of Action for Bile acid-binding resins
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Lowering bile acid concentration causes hepatocytes to increase conversion of cholesterol to bile acids
-excreted in feces |
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Therapeutic uses for BABR
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Cholestyramine relives pruritus in pts with biliary obstruction
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Adverse effects of BABR
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Constipation
Flatulence Impaired absorption of fat soluble vitamins |
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Drug interactions of BABR
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interferes with intestinal absorption of many drugs
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Inhibits intestinal absorption of dietary and biliary cholesterol in the small intestine
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Ezetimibe-- cholesterol absorption inhibitors
Leads to decrease in delivery of intestinal cholesterol to liver increased clearence of cholesterol in the blood |
