Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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

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