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Hyperlipoproteinemia
Pharmacology
32
Medical
Professional
11/19/2011

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Term
These drugs are transport inhibitors
Definition
cholestyramine
colestipol
colsevelam
Term
mech of action for resins
Definition
increase bile acid synth (this enhances HMG coA red

LDL rec. (uptakeing LDL)
Term
Overall effect of resins
Definition
decrease LDL
increase VLDL and triglyceride
Term
Clinical use of resins
Definition
**heterozygous** familial and polygenic hypercholesterolemia
Term
What should resins be used in combination w/ if pt. has HIGH triglycerides
Definition
Niacin
Term
This resin is effective for treating post-cholecystectomy diarrhea, and C. difficile diarrhea
Definition
Cholestyramine
Term
side effects of resisn
Definition
malabsorption of ADEK
Hyper Cl met acidosis
Term
Resins are contra'd in
Definition
hypertriglyceridemias, diverticulitis
Term
Mech of action for Ezetimibe
Definition
inhibits uptake of cholesterol by interfering w/transporter
Term
Overall effect of ezetimibe
Definition
decrease LDL-C
increase HDL-C
Term
Ezetimibe can act w/what to lower LDL
Definition
statins
Term
clinical use of Ezetimibe
Definition
Primary hypercholesterolemia
phytosterolemia
Term
Side effect of Ezetimibe
Definition
elevated liver enzymes
Term
Fibrate [ ] on ezetimibe
Definition
increase
Term
effect of resins on ezetimibe
Definition
intestinal absorption of ezetimibe is reduced.
Term
Statin mech of action
Definition
partially inhibit HMG coA reduc.
induces LDL receptor
**small INCREASE in HDL**
**decrease in triglycerides**
Term
the pleiotrophic effects of cholesterol
Definition
reduced inflammation
stabilization of plaques
reduced thrombogenic response
Term
Clinical use of statins
Definition
pts. at risk CAD
polygenic or familial HC

*prescribe these after CV events*
Term
Toxicity of statins
Definition
severe rhabdomyolysis, myoglobinuria, acute renal failure

impair mitochondria function
Term
Contra in statin use
Definition
lactation and pregnancy
secondary to rhabdomyosis
Term
statins + fibrates cause what toxicity?
Definition
muscle
Term
Niacin mech of action
Definition
inhibit FA release from stores
decrease VLDL apolipoproteins
decrease chylos and LDL
Term
clinical use of niacin
Definition
all types of hyperlipoproteinemia
EXCEPT ***hypertriglyceridemia****
Term
side effects of niacin
Definition
atrial fibrillation
incr. uric acid
flushing
Term
Niacin contra
Definition
DM
peptic ulcer
gout
hepatic dz
Term
Niacin does what to anti HTN's
Definition
potientates effect
Term
What are the fibrates
Definition
gemfibrozil, fenofibrate
Term
mech of action for fibrates
Definition
ligand for PPARa
decr VLDL and tri's,

LDL and cholesterol to a lesser extent

***increases HDL****
Term
What are fibrates used for
Definition
very HIGH serum triglyceride [ ]

DOC
Term
Side effects of Fibrates
Definition
cholelithiasis and cholecystitis
flu like syndrome
Term
What do fibrates enhance
Definition
anticoag effect of warfarin.
Term
what are some inducers of CYP3A4
Definition
Carbamazepine, phenytoin, phenobarbital, rifampin, St. John's wort
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