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Lipid Lowering Drugs; Hyperlipidemia

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zijimubo1's version from 2017-03-21 19:39

Section 1

Question Answer
AtorvastatinHMG-CoA Reductase Inhibitor
LovastatinHMG-CoA Reductase Inhibitor
EzetimibeCholesterol Uptake Inhibitor
GemfibrozilFibrate; propose activation of PPAR(peroxisome proliferator activator receptor)
Niacin (Nicotinic acid)Vitamin B3 - inhibits lipolysis in adipose tissue
CholestyramineBile acid binding resin
MipomersenInhibitor of B-100 synthesis
LomitapideTriglyceride transfer protein inhibitor
AlirocumabPCSK9 Inhibitor
EvolocumabPCSK9 Inihibitor
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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)
Agemales>45 post-menopause females>55
Blood pressureBP>140/90 or on hypertensive medications
LifestyleCurrent smoking
EndocrineDM2
Family Hx Premature Coronary Artery DiseaseCHD in male first degree relative <55 or female <65
Optimal LDL-C<100 mg/dL (2.6 mmol/L)
Border lineTotal 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 factorsadvise 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 factorsTreat w/ objective of achieving borderline to normal levels (LDL<160)
Pt has has high LDL > 160, with at least 2 risk factorsTreat 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 100-130drug therapy
Pt has diabetes, Coronary Heart Disease (CHD) or artherosclerotic disease and LDL-C > 130drug therapy with goal LDL<100 and TG<200
Pt has an HDL <40 (females <50)treat high risk patients
Pt has TG>200treat high risk patients or patients w/ consistent high levels
Pt has TC:HDL-C ratio < 3.5favorable not treatment
Pt has TC:HDL-C ratio > 4.5treatment even though LDL is in normal range
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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
Agehigher risk with age up to about 80
Total cholesterol(TC) <200desirable low risk
Total cholesterol >240High risk 2x greater
HDL protective value> 60
HDL < 40major risk factor
Nomal HDL range40-60
Gendermales higher risk
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Recommendations for pharmacological intervention

Question Answer
Atherosclerotic Cardiovascular Disease(ASVCD) <75 + no safety concernsHIGH intensity statin
Atherosclerotic Cardiovascular Disease(ASVCD) >75 + safety concernsMild intensity statin
Pt < 21yo with LDL-C>190high intensity to reduce 50% consider other non-statin therapy
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