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419 Hypolipidemic
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32
Pharmacology
Undergraduate 1
05/09/2011

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Term
Fibric Acid Derivatives
Definition
Gemfibrozil
Fenofibrate
Term
Nicotoinic acid
Definition
Niacin
Term
Bile acid binding resins
Definition
Cholestyramine
Colestipol
Colesevelam
Term
Stains
Definition
Atorvastatin
Pravastatin
Lovastatin
Term
What are Gemfibrozil and
Fenofibrate ligands for?
Definition
PPARalpha
Term
Gemfibrozil
Fenofibrate increases ______ catabolism and reduces _____
Definition
FA VLDL so you increase turnover of fats
Term
Gemfibrozil
Fenofibrate used to treat____
Definition
hypertriglyceridemias
Term
what mainly do Gemfibrozil
Fenofibrate do?
Definition
lower triglycerides and raise HDL
Term
Gemfibrozil
Fenofibrate pharmackinetics?
Definition
absorbed from GI and goes enterohepatic circulation.

eliminated through kidneys
Term
what are side effects?
Definition
rare cases of rash, GI symptoms, myopathy, arrhythmias, hypokalemia & high aminotransferase or alkaline phosphatase levels, risk of cholesterol gallstones.
Term
Drug interactions of Gemfibrozil
Fenofibrate
Definition
increase anticoagulent effect
Term
contraindications Gemfibrozil
Fenofibrate
Definition
dont use in pts with liver or renal dysfunction
Term
whats the major drug in nicotinic acid?
Definition
b naicin
Term
what does the nicotinic acid do?
Definition
treats combined dyslipidemias(excess lipid in blood)

lower LDL and VLDL levels

inhibit lipolysis in adipose tissue receptor...reduces camp and inhibits hormone sensitive lipase
-reduce FA, VLDL synthesis and LDL levels
-lowers triglycieride and LP
Term
what are some side effects of niacine?
Definition
flushing, hyperuricemia, glucose intolerance, and hepatic dysfunction
Term
what are some contraindicatins of niacin?
Definition
liver dz, gout, and DM
Term
what are bile acid binding resins?
Definition
colestipol and cholestryamine
Term
how do the c bile acid binding resins work?
Definition
binds bile acids in the intestine and its pooped out
prevent bile reasportion
b/c no bile acids in poop -> u have liver sensing u need more bile acids then you have increased oxidation of cholesterol to bile acids

Results: incerase in LDL RECEPTORS..and you lower LDL serum levels
Term
so what do colestipol and cholestyramine do?
Definition
lower ldl increase HDL and TG
Term
pharmacokinetics of bile acid binding resins?
Definition
not absorbed
Term
what are the side effects of bile acid binding resins?
Definition
consitpation-may cause increase in VLDL so add a naicain
if they dont have LDL receptor..then doesnt work. bc drug increases LDL receptor
Term
what are drug interacitons
Definition
interfere with normal fat digestion and abosrption
and stop absorption of VIT A D E K
Term
WHAT ARE D HMG co-a reducatase inhibitors?
Definition
statins
Term
what do the d hmg coa reductase inhibitors do?
Definition
they are competitive inhibitors of hmg-coa reducatse
they DEC LDL

induction leads to making lots of LDL receptors

lower serum LDL levels

increasing LDL receptors is the most imprortant part of the mech
Term
statins-what effect do they have on bones?
Definition
inhibit osteoclastic activity
Term
what are side effects of statins?
Definition
Elevations of serum aminotransferase, doesn't result in hepatotoxicity
In 2% of patients who have liver dz maybe have > 3x elevations in aminotransferase levels and that may indicate HEPATOTOXICITY

myositis(muscle pain)
rhabdomyolysis-> making myoglobinemia -> may lead to acute renal failure.
Term
Drug interacctions of statins
Definition
drugs that compete for CYP3A4 OR CYP2C9
Drugs that induce CYP will lower plasma statin levels
Term
Contraindications for statins
Definition
Preggers due to potential teratogenicity
Term
what does ezetimibe do?
Definition
lowers uptake of gi cholesterol(both dietary and biliary)

makes lots of high affinity ldl -> removal of LDL from blood
Term
waht effect does serum ldl and triglycerides does ezemtibme have?
Definition
it lowers it
Term
what are an indication with ezetimibe?
Definition
lots of cholesterol(hypercholesterolemia)
Term
how do u get toxicity with ezetimibe?
Definition
with HMG COA reducatse inhibitors
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