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Hyper lipoproteinemia
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18
Medical
Professional
08/13/2010

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Cards

Term
Cholestryamine, Colestipol (mechanism of action and clinical application)
Definition
Bile Acid Sequestrant; Bile Acid binding Resin

Used to treat Elevated LDL levels
Term
Cholestryamine, Colestipol (effect)
Definition
↑ the fecal excretion of bile salts and cholesterol; ↓ in cholesterol is also d/t up regulation of LDL receptors in the liver
Term
Cholestryamine, Colestipol (side effect other jazz)
Definition
SE: Constipation, Deficiency of Fat Soluble vitamins, Increased Triglycerides (ppt. pancreatitis)

NB: These binding resins are neither digested nor absorbed

NB: There is a compensatory ↑ in the activity of HMG CoA reductase resulting in ↑ cholesterol synthesis & ↑ VLDL secretion (Transient effect)
Term
Lovastatin, Simvastatin (mechanism of action and clinical use)
Definition
HMG CoA reductase Inhibitor

Used to treat elevated LDL levels; Cardio protective actions
Term
Lovastatin, Simvastatin (effect)
Definition
• ↑ in LDL receptor expression on the liver; Hepatic synthesis of VLDL is ↓; ↑ in HDL
• Also has cardio protective actions: ↑ endothelial NO synthesis, plaque stability, anti-inflammatory action, ↑ activity of paraoxonase (anti-oxidative enzyme); anti-coagulation
Term
Lovastatin, Simvastatin (side effects other jazz)
Definition
SE: Headaches, Sleep disturbances, Hepatotoxicity, Myopathy (Rhabdomyolysis)
Contraindication: Pregnancy (b/c inhibits progesterone)

NB: Both drugs are lipid soluble, so they can cross the BBB and cause side effects: headaches ; Metabolized by CYP450
Term
Atorvastatin , Rosuvastatin (mechanism of action and clinical use)
Definition
HMG CoA reductase Inhibitor

Used to treat elevated LDL levels; Cardio protective actions (↓VLDL = ↓ TG)
Term
Atorvastatin , Rosuvastatin (effect)
Definition
• ↓Liver Cholesterol
• ↑ in LDL receptor expression on the liver; Hepatic synthesis of VLDL is ↓; ↑ in HDL
• Also has cardio protective actions: ↑ endothelial NO synthesis, plaque stability, anti-inflammatory action, ↑ activity of paraoxonase; anti-coagulation
Term
Atorvastatin , Rosuvastatin (side effects and other jazz)
Definition
SE: Sleep disturbances, Hepatotoxicity, Myopathy (Rhabdomyolysis)

Contraindication: Pregnancy (b/c inhibits progesterone)

NB: These drugs do not cross the BBB; Atovastatin has an anti-oxidant effects; Rosuvastatin is the MOST potent; Metabolized by CYP450
Term
Fenofibrate ; Gemfibrozil (mechanism of action and clinical use)
Definition
Fibric Acid Derivatives; PPAR α agonist

Works best to treat High Triglycerides
Term
Fenofibrate ; Gemfibrozil (effect)
Definition
• Act by activating lipoprotein lipase (LPL) which is a key enzyme in the degradation of VLDL--- resulting in lowering of TG, also ↓ VLDL secretion, ↓ LDL levels, ↑ HDL synthesis
Term
Fenofibrate ; Gemfibrozil (side effects and other jazz)
Definition
SE: Gallstones, Myopathy

NB: PPAR α agonist involved in the regulation of carbohydrate & lipid metabolism (causes transcript. of a # of genes of DNA that facilitate lipid metabolism)
Term
Nicotinc Acid (mechanism of action and clinical use)
Definition
Broad spectrum antihyperlipidemic drug

Works Best to treat low HDL levels d/t ↑ LDL &/or TG
Term
Nicotinc Acid (effect)
Definition
• ↓ VLDL & TG production results in a ↓ exchange of Cholesterol esters & TG & a subsequent ↑ in HDL
• Acts on a G-protein to ↓ cAMP, ↓ activity of HSL which ↓FA in circulation
Term
Nicotinc Acid (side effects)
Definition
SE: Cutaneous Dilator (flushing, itching), Liver dysfunction, Gout, Hyperglycemia (do not want to give to DM patient)
Term
Ezetimibe (mechanism of action and clinical use)
Definition
Antihyperlipidemic

Used to Lower Cholesterol
Term
Ezetimibe (effect)
Definition
• Inhibits cholesterol absorption by enterocytes of the small intestine by localizing at the brush border
• Ultimately this leads to a ↓ cholesterol absorption which leads to an ↑ in LDL-Cholesterol uptake into cells, thus ↓LDL & TG levels in the plasma
Term
Ezetimibe (other jazz)
Definition
NB: Can be used in combination with a statin which has been shown to lower cholesterol by 25% more than a statin alone
(Ezetimibe + Simvastatin = Vytorin)
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