Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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

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