Term
Coronary Artery Disease
(CAD)
manifestations |
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Definition
asymptomatic--> angina --> MI
-leading killer in the US
-important connection btwn high cholesterol and CAD |
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Term
|
Definition
needed for life
-primary source endogenous (genetic)
-also ingetion of saturated fats stimulates cholesterol synthesis |
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Term
|
Definition
lipid+ptn
-transport method for fatts in blood |
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Term
|
Definition
-HDL: goood, we want high levels
-LDL: BAD, we want low levels |
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Term
first action to prevent or treat
CAD? |
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Definition
LIFE STYLE CHANGES
-must happen first and must be continued through out treatment and life |
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Term
| Classes of Lipid Lowering Rx? |
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Definition
HMG CoA reductase inhibitors
Nicotinic Acid
Bile Acid-Binding Resins
Fibric Acid Derivatives (fibrates)
Ezetimibe |
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Term
| HMG CoA reductase inhibitors |
|
Definition
-enzyme in liver that is critical in cholesterol synthesis
-inhibition causes more enzyme to be made and more receptors
--net effect is increased liver uptake of LDL from serum
DOC
-dec incidence of CVA |
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Term
LDL Lowering Rx
HMG CoA Reductase Inhibitor Rxs
|
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Definition
-_____+statin
-drug interactions differ
-ADRS: dose related
--hepato tox
--myopathy: leading to myositis and rhadomyolysis |
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Term
rhabdomyolysis
definition |
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Definition
happens with renal impairment and statin use
-breakdown of skeletal muscle
--muscle weakness and pain |
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Term
LDL Lowering Rx
'statin interactions |
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Definition
-not mixed with fibrates
-not mixed with CYP3A4 inhibitors
-category X |
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Term
LDL Lowering Rx
Nicotinic Acid |
|
Definition
(Niacin)
-deg TG (better than most)
-dec LDL (less than statins)
-inc HDL (better than most)
ADR's
flushing, GI, Hepato tox, hyperglycemia and hyperuricemia |
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Term
LDL Lowering Rx
Bile Acid-Binding Resins
over view |
|
Definition
bind to block absorption of bile acids in GI
-provokes liver to produce more
-inc LDL receptors in liver cause cholesterol makes bile salts
-peak delayed 4 weeks
-usually combined with statin
ARDS: constipation and dec fat soluable vit absorption |
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Term
LDL Lowering Rx
Bile Acid-Binding Resins
Rx |
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Definition
-cholestyramine
-colestipol
-colesevelam (most tolerated, $$$) |
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Term
LDL Lowering Rx
Fibric Acid (fibrates)
mechanism and ADRs |
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Definition
-mechanism dealing with apolipoptns
major indication to decrease TG
-ADR's: rash, ND pain, gallstones, hepatatox, myopathy |
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Term
LDL Lowering Rx
Fibrate Rx |
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Definition
added after statin
-gemfibrozil
-fenofibrate
-choline fenofibrate (fenofibric acid) |
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Term
LDL Lowering Rx
Ezetimibe
|
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Definition
-blocks cholesterol absorption at the brushboarder in the GI
-dec LDL and inc HDL
ADRS limited |
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