Miscellaneous / Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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

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