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Hyperlipidemics

USMLE Step 1

DrugMOA & ADRs
Type 1: Familial Lipoprotein Lipase Deficiency deficiency of 1) lipoprotein lipase, 2) abnml lipoprotein lipase, 3) apo-C2 defects leading to increases in chylomicrons, TGs; autosomal recessive; not atherogenic, so tx is to lower fat intake
Type 2A: Familial Hypercholesterolemia defect of the LDL receptor, causing elevations in LDL & cholesterol; autosomal dominant; very atherogenic
Type 2B: Familial hypercholesterolemia mutant apolipoprotein B100, resulting in increased levels of LDL, VLDL, cholesterol & TGs; autosomal dominant; very atherogenic
Type 3: Familial dysbetalipoproteinemia mutant apo E, resulting in increased cholesterol & TGs, as well as 'floating LDLs'; very atherogenic
Type 4: Familial Hypertriglyceridemia due 2 overprod of VLDL in assoc w/ glucose intolerance & hyperinsulinemia (increase VLDL & TGs); autosomal dominant; mildly atherogenic; increases one risk of pancreatitis; most common inherited hyperlipidemia
Type 5: Familial Hyperlipoproteinemia similar to Type 1 defect in LPL or apo C2, causing increased levels of VLDL, chylomicrons & TGs; mildly atherogenic; increases one's risk for pancreatitis
Niacin MOA:decreases hepatic intake of released FAs,- lipolysis in fat cells,increases HDL,decreases LDL, increasing efficacy of resins(bile acid?),decreased TGs,increased chylomicron & VLDL clearance from bld,4 type 2B;ADRs:severe cutaneous flushing & pruriti
Clofibrate MOA:fibric acid increases lipoprotein lipase activity 2 decrease chylomicron & VLDL levels,tx 4 hyperlipidemia types 3 & 4,increase several apoprotein receptor recognition sites 2 increase lipoprotein uptake by liver;ADR:gallstones,dysrhythmias,malignancy
Fenofibrate MOA: fibric acid agent increases lipoprotein lipase activity 2 decrease chylomicron & VLDL levels, tx 4 hyperlipidemia, increase several apoprotein receptor recognition sites 2 increase lipoprotein uptake by liver; ADRs: gallstones,dysrhythmias,malignancy
Gemfibrozil MOA: fibric acid agent increases lipoprotein lipase activity 2 decrease chylomicron & VLDL levels, tx 4 hyperlipidemia, increase several apoprotein receptor recognition sites 2 increase lipoprotein uptake by liver; ADRs: gallstones,dysrhythmias,malignancy
Colestipol MOA:bile acid sequestrant binds cholesterol in gut,increased liver cholesterol syn that increases liver serum LDL intake & decreases plasma LDL,used in types 2 A & B;ADRs:major contraindication is hypertriglyceridemia,- absorption of many drugs
Colesevelam MOA: bile acid sequestrant binds cholesterol in the gut, increased liver cholesterol syn that increases liver serum LDL intake & decreases plasma LDL; ADRs: major contraindication is hypertriglyceridemia
Atorvastatin MOA: HMG-CoA reductase - (statin), decrease rate-limiting step of cholesterol syn, esp in hepatocytes, decrease pool of intracell cholesterol cause increased uptake of serum LDL = less cholesterol in bld; ADRs: hepatotoxic, myopathy esp w/ niacin
Fluvastatin MOA: HMG-CoA reductase - (statin), decrease rate-limiting step of cholesterol syn, esp in hepatocytes, decrease pool of intracell cholesterol cause increased uptake of serum LDL = less cholesterol in bld; ADRs: hepatotoxic, myopathy esp w/ niacin
Pravastatin MOA: HMG-CoA reductase - (statin), decrease rate-limiting step of cholesterol syn, esp in hepatocytes, decrease pool of intracell cholesterol cause increased uptake of serum LDL = less cholesterol in bld; ADRs: hepatotoxic, myopathy esp w/ niacin
Rosuvastatin MOA: HMG-CoA reductase - (statin), decrease rate-limiting step of cholesterol syn, esp in hepatocytes, decrease pool of intracell cholesterol cause increased uptake of serum LDL = less cholesterol in bld; ADRs: hepatotoxic, myopathy esp w/ niacin
Simvastatin MOA: HMG-CoA reductase - (statin), decrease rate-limiting step of cholesterol syn, esp in hepatocytes, decrease pool of intracell cholesterol cause increased uptake of serum LDL = less cholesterol in bld; ADRs: hepatotoxic, myopathy esp w/ niacin
Cholestyramine MOA:bile acid sequestrant binds cholesterol in gut,increased liver cholesterol syn that increases liver serum LDL intake & decreases plasma LDL,used 4 types 2A & B;ADRs: major contraindication is hypertriglyceridemia & - many drug absorption
Lovastatin MOA:HMG-CoA reductase -,decrease rate-limiting step of cholesterol syn,esp in hepatocytes,decrease pool of intracell cholesterol=increased uptake of serum LDL=less cholesterol in bld,4 types 2A & B;ADRs:hepatotoxic,myopathy esp w/ niacin,contra in pregger
Diet MOA: most important factor in improving all types of hyperlipidemia, the ONLY option for Type 1
Created by: jerrica_08
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