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Antilipidemics
Controlling high cholesterol (fat)
| Term | Definition |
|---|---|
| Atherosclerosis | Buildup of plaque, major contributor to heart disease, heart attack, and stroke |
| Cholesterol LDL | LDL: low-density lipoproteins: BAD - transport cholesterol to peripheral cells - elevation of LDLS causes: atherosclerotic plaque forms + inc. risk for heart disease |
| Cholesterol HDL | HDL: high-density lipoproteins: GOOD - take cholesterol from peripheral cells and transport it to the liver to be metabolized and excreted |
| Risk for heart disease and high cholesterol | - Spanish men and African American men have increased risk for high LDL, women have an increased risk for high LDL, family history - *Diet, weight, and exercise can help |
| Serum cholesterol levels associated with atherosclerosis | **** > 240 mg/dL & triglyceride levels > 150 mg/dL |
| HMG-CoA Reductase Inhibitors (**Statins) - first choice for high cholesterol | - Use: Reductase is a catalyst in making of cholesterol, take to prevent a coronary event - Prototype: ***atorvastatin (mild, GI related) - *Might cause hyperglycemia in non diabetic patients - No grapefruit juice, no pregnancy, cautious with liver di |
| What time should you take antilipidemic drugs? | Take any antilipidemic drug at night |
| PCSK9 Inhibitor - work well, but very expensive | - For patients with a strong history of hyperlipidemia or at a high risk for cardiovascular disease - Prototype: alirocumab - Sub Q injection once a month - ADRs: GI |
| Bile Acid Resins | - Binds to bile acids and make sure the fat is excreted, liver then uses cholesterol to make more which helps lipids decrease - Bile: emulsifies fats and lipids and then they are absorbed into intestine |
| Rosuvastatin | Linked to muscle toxicity (Rhabdomyolysis) especially in Asian patients |
| Bile Acid Resins Continued | - ***Decrease serum levels of a LOT of medications, do not play well with others - ***So, administer ALONE (4 hours before or after other medications) - Reduces absorption of fat soluble medicines |
| Fibric Acid Derivatives (Fibrates) | - Prototype: gemfibrozil - Reduce production of triglycerides by the liver, but also can increase excretion of cholesterol in feces which lowers serum levels - ADRs: GI, nausea, **Cholelithiasis: gallstones |
| Niacin | - Adjunct therapy, also lowers serum triglyceride levels - *Causes severe generalized flushing of the skin (red face) - Flushing will get better the longer it is taken (aspirin might help with flushing) |
| Herbal Considerations | - Red yeast rice: shown to lower cholesterol, do not take with a "statin" - can cause serious liver damage - Garlic tablets: lowers serum cholesterol and triglycerides, lowers BP |
| Xanthomas | Yellow lipid pockets - shows severe forms of hyperlipidemia |
| Rhabdomyolysis | - Muscle tissue damage that releases CK (creatine kinase) in the bloodstream - Occurs normally after not moving 10-12 hours (passed out) - Associated with statins - Liver enzymes increased - CK levels 5x normal |
Created by:
alowe26
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