Drugs for Lipid Disorders

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Drugs for Lipid Disorders

• Chapter 20

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Lipids

• Hyperlipidemia excessive lipids in blood
• 3 lipid types
• Triglycerides major storage form of fat,
  provide energy 90 of total lipids
• Phospholipids essential to building plasma
  membranes
• Steroids cholesterol is most common type

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Cholesterol (lt200)

• Promotes atherosclerosis (blockages in arteries)
• Essential for life in minute amounts
• May be synthesized by liver is not a dietary
  requirement
• Dietary cholesterol comes from animal products
• Eliminated via intestines

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Lipoproteins

• Complexes of cholesterol, triglycerides,
  phospholipids, and protein carrier
• High density lipoproteins (HDL) transport
  cholesterol to liver for bile synthesis, bile
  cholesterol is then excreted in feces good gt
  40
• Low density lipoproteins (LDL) contribute to
  deposition of blockages in arteries bad lt 100

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Lifestyles changes for increased cholesterol

• Maintain optimum weight
• Exercise
• Decrease stress
• Decrease saturated fat and cholesterol in diet
• Increase soluble fiber in diet
• Tobacco cessation

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HMG CoA Reductase Inhibitors (statins)
(atorvastatin)

• First choice for dyslipidemia
• Slow synthesis of cholesterol in liver
• 20-40 reduction in LDL
• Decrease triglycerides, increase HDL
• May be taken without regard to food or time of
  day
• Side effect rare liver damage ? monitor liver
  function tests pregnancy category X

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Bile acid resins (cholestyramine)

• Bind to bile acids (in intestines) which contain
  large amounts of cholesterol
• Side effects GI complaints may bind to other
  drugs

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Nicotinic acid (niacin)

• B complex vitamin
• Improves all lipoprotein abnormalities
• Side effect flushing, GI complaints

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Fibric acid agents (gemfibrozil)

• Mechanism of action not understood
• Best for decreasing triglycerides
• Side effects GI complaints