statin; HMG-CoA reductase inhibitor.  Blocks formation of cholesterol, which also causes liver to make more LDL receptors, so both cholesterol and LDL are reduced. [p. 287-8]

Sd ef: headache, fatigue, muscle / joint pain, heartburn.

Adverse: myopathy & rhabdomyolysis (both rare, but rhab increases with microlide antibiotics, cyclosporines, azole antifungals & niacin); possible liver damage

It jacks up digoxin, norethindrone & oral contraceptives.

Grapefruit juice inhibits metabolism of statins.

Take statin w/ evening meal.

bile acid resin - sequestrant; binds with bile acids containing cholesterol in the GI; the insoluble product is excreted [p.289].    

Sd eff: bloating, gas, nausea, constipation.   Contra for total biliary obstruction, or prev. pbm. 

D-D: binds with digoxin, penicillins, thyroid hormone & thiazide diuretics.  W/food, absorption problem for vitamins B₁₂, D, E, K; and B-carotene, Ca, folic acid, Fe, Z, and Mg.

Take powder/granules B4 meals w/ lots of H₂O; other meds 1 hr B4 or 4 hr af.

B-complex vitamin; 2-3 g/day lowers VLDL levels, indirectly decreasing LDL / cholesterol (only use 25 mg as vitamin) & triglycerides; raises HDL.

Take an aspirin 30 mnt prior to reduce flushing.  Other sd. eff: hot flashes, nausea, gas, & diarrhea

Contra: diabetes mellitus; raises fasting blood glucose.

for ATP in mitochondria; increased need by the elderly.  Beneficial for angina pectoris, dysrhythmias, periodontal disease, immune disorders, obesity, diabetes.  Many of the side effects of statins may be from interference with CoQ10 secondary to inhibition of enzyme HMG-CoA

Evidence to support treating neurologic disease, cancers or heart disease is weak.

[online sources say meat, eggs (boiled), fish, almonds, spinach & broccoli]

fibric acid agent; reduces VLDL up to 50% w/ increase in HDL; less effective lowering LDL than statins, but preferred for treating hypertriglyceridemia; often combined with a statin

Sd. eff: dyspepsia (indigestion), diarrhea, nausea, cramping

Contra: hepatic, gallbladder or renal impairment

Mechanism unknown

3: a) triglycerides - glycerol w/ 3 fatty chains attached; neutral fats; 90% of total lipids in body, the only energy lipid 

 b) phospholipids - phosphate group replaces one fatty chain in a triglyceride; essential to plasma membranes; lecithin is best known but not functional for reduction of cholesterol nor Alzheimer's

c) steroids - ring structure (sterol nucleus); cholesterol is best known and promotes artherosclerosis.  

Is a steroid; the building block for Vitamin D, bile acids, cortisol, estrogen, and testosterone.

It also causes atherosclerosis.

The liver can synthesizes adequate cholesterol; cholesterol is unnecessary in the diet.  Cholesterol biosynthesis tends to be higher at night.

An apoprotein (protein carrier group; "apo-" = derived from) attached to the insoluble lipid molecule in order to transport the lipid through the blood.  

HDL - mostly (about 50%) protein; the "good 1"; transports LDL (mostly cholesterol; "bad") back to liver for destruction; made in liver & small intestine.  VLDL ("bad"; mostly triglycerides) is a building block for LDL. 

For men, need LDL to HDL of <5.0; women <4.5

mg/dL: total lidpids <200 good; >239 is high risk

LDL <100 = good; 160 to 189 = high risk; >190 = very high risk

HDL: <40 =low; >60 is good

triglycerides <150 = normal; 200 to 499 = high risk; >500 = very high risk

1) monitor blood lipid levels regularly per provider.   2) optimum weight   3) exercise plan

4) minimize saturated fats & cholesterol (<300 mg/day for chol., but liver will synthesize if low and inhibit excretion if sat. fat is present; so must reduce both.)

5) maximize soluble fiber (oat bran, apples, beans &      broccoli)   6) eliminate tobacco use

Plant sterols / stanols (corn, rye, oats, rice, nuts, olive oil) cause cholesterol to be excreted from body.