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versions of Lipid Lowering Drugs; Hyperlipidemia:
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Lipid Lowering Drugs; Hyperlipidemia
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Section 1
| Question | Answer |
|---|
| Atorvastatin | HMG-CoA Reductase Inhibitor |
| Lovastatin | HMG-CoA Reductase Inhibitor |
| Ezetimibe | Cholesterol Uptake Inhibitor |
| Gemfibrozil | Fibrate; propose activation of PPAR(peroxisome proliferator activator receptor) |
| Niacin (Nicotinic acid) | Vitamin B3 - inhibits lipolysis in adipose tissue |
| Cholestyramine | Bile acid binding resin |
| Mipomersen | Inhibitor of B-100 synthesis |
| Lomitapide | Triglyceride transfer protein inhibitor |
| Alirocumab | PCSK9 Inhibitor |
| Evolocumab | PCSK9 Inihibitor |
| memorize |
Abnormalities in Circulating Lipoproteins
| Question | Answer |
|---|
| What are the components of the Lipid triad? | Elevated TG, LDL-C, HDL-C |
| Lipid Triad indicative of higher risk of? | Coronary Heart Disease (CHD) |
| Age | males>45 post-menopause females>55 |
| Blood pressure | BP>140/90 or on hypertensive medications |
| Lifestyle | Current smoking |
| Endocrine | DM2 |
| Family Hx Premature Coronary Artery Disease | CHD in male first degree relative <55 or female <65 |
| Optimal LDL-C | <100 mg/dL (2.6 mmol/L) |
| Border line | Total cholesterol < 200-240 LDL cholesterol < 130-160 TG < 150-200 |
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ATPIII Recommendations for treatment
| Question | Answer |
|---|
| Pt has has borderline LDL 130-166, but no other risk factors | advise diet |
| Pt has has borderline LDL 130-166, with at least 2 risk factors | advice diet/exercise, potential drug w/ goal of <130 |
| Pt has has high LDL > 160, but no other risk factors | Treat w/ objective of achieving borderline to normal levels (LDL<160) |
| Pt has has high LDL > 160, with at least 2 risk factors | Treat w/ objective of achieving less than normal levels (LDL<130 recent studies <100) |
| Pt has diabetes w/ Coronary Heart Disease (CHD) or artherosclerotic disease and LDL-C of 100-130 | drug therapy |
| Pt has diabetes, Coronary Heart Disease (CHD) or artherosclerotic disease and LDL-C > 130 | drug therapy with goal LDL<100 and TG<200 |
| Pt has an HDL <40 (females <50) | treat high risk patients |
| Pt has TG>200 | treat high risk patients or patients w/ consistent high levels |
| Pt has TC:HDL-C ratio < 3.5 | favorable not treatment |
| Pt has TC:HDL-C ratio > 4.5 | treatment even though LDL is in normal range |
| memorize |
ACC/AHA guidelines for treatment
| Question | Answer |
|---|
| What is the ACC/AHA guidelines for treatment? | Focus on presence of disease and 10 yr risk of having a heart attack |
| Age | higher risk with age up to about 80 |
| Total cholesterol(TC) <200 | desirable low risk |
| Total cholesterol >240 | High risk 2x greater |
| HDL protective value | > 60 |
| HDL < 40 | major risk factor |
| Nomal HDL range | 40-60 |
| Gender | males higher risk |
| memorize |
Recommendations for pharmacological intervention
| Question | Answer |
|---|
| Atherosclerotic Cardiovascular Disease(ASVCD) <75 + no safety concerns | HIGH intensity statin |
| Atherosclerotic Cardiovascular Disease(ASVCD) >75 + safety concerns | Mild intensity statin |
| Pt < 21yo with LDL-C>190 | high intensity to reduce 50% consider other non-statin therapy |
| memorize |
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zijimubo1's
version from
2017-03-21 19:39
