Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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Cholestyramine
Contraindicated in pregnancy and liver dz
Colestipol
Decreases LDL
Single agent to treat familial dysbetalipidemia
Contraindicated in kidney, liver, and biliary dz
SE: flushing, itching, GI upset, hepatic dysfunction, hyperuricemia, tachyarrhythmias
Contraindicated in dysbetalipoproteinemia (TG>400) and relatively contraindicated in TG >200
Gemfibrozil
Simvastatin
Downregulates apo CIII
Niacin/Nicotinic acid/Vit B3
Fenofibrate
Fluvastatin
Inhibits NPC1L1 transport in the gut
Single agent to treat hyperlipoproteinemia (type I) or familial hypertriglyceridemia (type IV)
Drug interaction with digitalis, warfarin, statins, aspirin, ascorbic acis, iron AND a decrease in fat soluble vitamins
Lovastatin
Decreases CRP
QuestionAnswer
Colesevelam
Must monitor creatine kinase
Decreases LDL and TG
Synergistic with statins
Decreases VLDL, LDL, Lp(a) and increases HDL
Use 2-3 of these agents to treat defective apo-B or familial hypercholesterolemia (Type IIa)
Competitively inhibits HMG-CoA reductase
Use 2 - 3 of these agents to treat familial combined hyperlipoproteinemia
Rosuvastatin
SE: Gallstones, elev liver enzymes, increased action of oral anticoagulants
Pravastatin
Anion exchange resin prevents bile acid binding
Ezetimibe
Upregulates LPL, apo AI, AII
Decreases VLDL and TG, increases LPL activity
Contraindicated in DM, peptic ulcers, chronic liver dz, gout
Decreases FFA to liver
Atorvastatin
Take this drug to decrease flushing with Niacin

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