Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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

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