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26 Cards in this Set
- Front
- Back
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What are lipoproteins and what do they do? |
complexes of lipid and apoprotein transport triglyceride/cholesterol through blood |
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Rank the following in order of density. LDL VLDL HDL chylomicrons |
chylomicrons VLDL LDL HDL |
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Can VLDL pass through blood vessel wall? |
no |
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Can LDL pass through blood vessel wall? |
yes |
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What does HDL do? |
accepts excess cholesterol |
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triglyceride or cholesterol? chylomicrons, VLDL, LDL, HDL |
triglyceride--chylomicrons, VLDL cholesterol--LDL, HDL |
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What is the progression of atherosclerosis |
1) foam cells 2) fatty streak 3) intermediate lesion 4) atheroma 5) fibrous plaque 6) complicated lesion/rupture |
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What is taken up by macrophages and become fatty streaks? |
oxidized LDL |
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What are the macrophages that take up oxidised LDL called? |
foam cells |
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What is the exogenous pathway for lipoprotein transport in the blood? |
cholesterol/triglycerides derived from GIT --> intestinal lymph --> transported as chylomicrons --> plasma --> hydrolyzed --> muscle/adipose tissue |
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What is the endogenous pathway for lipoprotein transport in the blood? |
cholesterol/triglycerides synthesised in the liver --> transported as VLDL --> muscle/adipose tissue --> hydrolysed --> lipoprotein particles become LDL and provides cholesterol |
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What are the 5 lipid lowering agents? |
1) statins 2) fibrates 3) inhibitors of cholesterol absorption 4) nicotinic acid 5) fish oils |
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What is the mode of action of statins? |
block cholesterol synthesis in the liver competitive enzyme inhibitor decreased LDL, decreased TG, increased HDL |
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What are the ADRs of statins? |
GI disturbances, insomnia, rash, myopathic effects avoid in pregnancy risk of diabetes and memory loss |
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Clinical uses of statins primary prevention of what? secondary prevention of what? |
primary--arterial disease secondary--myocardial infarction and stroke |
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What is the mode of action of fibrates? |
peroxisome proliferator activated receptor alpha agonists stimulates lipoprotein lipase in muscle and adipose tissue decreases hepatic VLDL production increases hepatic LDL uptake decreases LDL, decreases TG, increases HDL |
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What are the ADRs of Fibrates? |
GI disturbance |
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What are bile acids? |
formed from cholesterol in liver aid absorption of dietary fat pass into gut in bile reabsorbed in terminal ileum |
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What is the mechanism of action of bile acid binding resins? |
--bind bile acids --decrease absorption of exogenous cholesterol --increase metabolism of endogenous cholesterol to bile salt --decrease intracellular cholesterol in hepatocytes --compensatory increases in LDL receptors |
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What are the ADRs of bile acid binding resins? |
GIT |
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What is the mechanism of action of cholesterol absorption inhibitors? |
ezetimibe inhibits cholesterol absorption across intestinal wall blocks transport protein NPC1L1 in brush border |
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Do cholesterol absorption inhibitors affect fat soluble vitamin absorption? |
no |
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What is the mechanism of action of nicotinic acid? |
unclear inhibits VLDL secretion from liver decreases Lp(a)--acts like plasminogen and promotes thrombosis decreased LDL, decreased TG, increased HDL |
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Choice of drug treatment for hypercholesterolemia. |
**statins** bild acid binding resins nicotinic acid, exetimibe fibrates |
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Choice of drug treatment for hypertriglyceridemia. |
**fibrates** nicotinic acid fish oils |
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Choice of drug treatment for mixed dyslipidamia. |
combos |
