Question | Answer |
what are the two forms of lipids in the blood | triglycerides and cholesterol |
what are apolipoproteins | specialized lipid carrying proteins |
what is lipoprotein | combo of triglyderides or cholesterol with apolipoprotein |
what are the types of lipoproteins | VLDL- very low density lipoproteins
LDL- low density
HDL- high density |
what does HDL do | recycle cholesterol and is the good cholesterol |
what level of cholesterol makes someone risk for CHD | >300mg/dl 3-4x greater than <200mg/dl |
What are positive risk factors for CHD | male 45+, female 55+, family hx, smoker, BP 140/90+, HDL <40 |
what are negative risk factors (beneficial) | high HDL >60 |
What do antilipemic drugs do | lower lipid levels, adjunct to diet therapy |
how long should non-drug means of lowering lipid levels be attempted before drug therapy | 6 months and then fail |
What are the classes of antilipemics (6) | HMG-CoA reductase inhibitors(HMGs or statins)
bile acid sequestrants
Niacin
Fibric acid derivitives (fibrates)
Cholesterol absorption inhibitor (Zetia)
Combination drugs (Vytorin) |
How do HMGs or statin reduce lipids | inhibit HMG-CoA reductase which is used by liver to produce cholesterol, block liver from producing cholesterol, first line drugs |
What is an adverse affect for statins | myopathy, muscle pain which can lead to rhabdomyolysis(destroyed muscle cells) |
What are the bile acid sequestrants | cholestyramine(Questran)
colestipol hydrocholoride(Colestid)
colesevelam(tablet form) |
how do bile acids sequestrants work | bile acids are necessary for absorption of cholesterol, they gather up bile and prevent reabsorption of bile acids from sm. intestine |
Bile acids reduce cholesterol how | natural way liver excretes cholesterol, the more bile acids excreted in feces, more the liver converts cholesterol to bile acids. reduces chol. in liver |
What are the indications of bile acids | mgmt of type II hyperlipoproteinemia and alongside statins |
what are adverse affects of bile acid sequestrants | constipation, heartburn, N, bleching, bloating |
What vitamin is Niacin | vitamin B3, need lg doses to lower cholesterol |
how is niacin affective in lowering cholesterol | lowers triglycerides, total serum cholesterol and LDL levels and incr HDL.
Reduce metabolism/catabolism of triglycerides and cholesterol |
what are adverse affects of niacin | flushing, pruritis, GI distress, can take NSAIDs 30 min before, take weeks to work |
What are two fibric acid derivatives | gemfibrozil(Lopid), fenofibrate(Tricor) |
what is the mechanism of action for fibric acid derivatives | decr triglycerides, incr HDL 25%, suppress release of free fatty acids from adipose |
what are adverse affects of fibric acid derivatives | blurred vision..."fiber in your eyes", constipation esp. Clofibrate so incr fiber in diet |
What is a cholesterol absorption inhibitor | Zetia |
what are some herbal products that help lower cholesterol | garlic, flax, Omega 3, interactions with Warfarin |