Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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

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