Lipid Lowering Agents

Can you name the Lipid Lowering Agents?

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

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