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20 Cards in this Set
- Front
- Back
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Hyperlipidemia and disease
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- A defect in the transport system that carries cholesterol and triglycerides to the cell
- Increased lipids and cholesterol => coronary artery disease - Increased pancreatitis - Deposition of excess lipids in skin, eyes, and tendons |
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Desirable cholesterol levels
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< 200 mg/DL total and < 100 mg/DL of LDL
- 200 -239 total & 130-159 => death rate doubles - 240-329 total & >160 => 4x death rate |
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What happens to excess LDL?
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- It is oxidized and taken up by macs and deposited in blood vessel lining => atherosclerotic plaques
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Secondary hyperlipoproteinemias
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Cirrhosis
Nephrosis Alcoholism Diabetes Hyperthyroidism Thiazide Glucocorticoids |
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Primary hyperlipoproteinemias
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Genetic abnormalities
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Non-pharmacologic Tx of hyperlipidemias
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Lifestyle changes
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Pharmacologic Tx of hyperlipidemias
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- Dec production of lipoproteins
- Inc breakdown and removal of lipoprotein - Dec absorption from gut |
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HMG CoA Reductase Inhibitors
(Statins) |
- Most powerful LDL lowering agents
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Mech of action of statins
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- Inhibits the enzyme that is the rate limiting step in cholesterol synthesis of the cell (shutting down de-novo synthesis)
- Increased production of LDL receptors - Dec VLDL synthesis - Dec triglycerides |
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Side Effects of statins
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Myositis
Liver toxicity Teratogenic at high doses Reversible memory loss w/ some |
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Niacin (Nicotinic acid)
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- Inhibits the enzyme (diacyl glycerol acetyl transferase) at high doses
- Dec VLDL and triglycerides - Inc HDL |
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Side effects of Niacin (3)
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1- Cutaneous flushing (dec this w/ aspirin)
2- Gout 3- Inc liver enzymes Available in extended release forms |
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Bile acid binding resins (3)
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1- Cholestyramine
2- Colestipol 3- Coleselevam |
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Mech of action of bile acid binding resins
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- Bind irreversibly to bile acids in intestines
- Cause bile acids to be excreted => liver uses more cholesterol to make new bile acids; dec fat absorption from the gut |
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Side effects of bile acid binding resins (4)
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- Not systemically absorbed
- Irreversibly bind to other drugs so that they don't get absorbed - Dec fat soluble vitamin absorption - Constipation |
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The Fibrates (2)
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1- Gemfibrozil
2- Fenofibrate - Mech of action: Binds to PPAR (receptor) and causes increase in lipoprotein lipase - SE: nausea and gallstones |
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Omega 3 Fatty Acids
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- Dec triglycerides and inc HDL
-SE: nausea, burping, farting |
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Agents that decrease cholesterol absorption by the intestines (4)
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1- Ezetimibe: blocks cholesterol transporters in intestines and doesn't become systemic; SE is farting
2- Sitostanol: cholesterol analog that dec cholesterol absorption 3- Orlistat: inhibits GI and pancreatic lipases; dec fat absorption 4- Olestra |
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Lipoprotein lipase does what?
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Breaks down chylomicrons onto free fatty acids which can be taken up by the cell
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HDL is produces by the __ and taken up by the __
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Liver
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