Miscellaneous Quiz / Lipid Lowering Agents

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Can you name the Lipid Lowering Agents?

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

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