Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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

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