Cholesterol-lowering drugs

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  1. Who should take lipid-lowering drugs?
    At risk groups for cardiovascular disease, e.g. familial hypercholesterolaemia, diabetics over 40, HTN.

    Q-risk >20%

    For primary and secondary prevention of cardiovascular disease
  2. What conservative measures should be advised when trying to lower lipid levels?
    Diet, exercise, smoking cessation, reduced alcohol consumption and weight management
  3. What other drugs should be considered when prescribing lipid-lowering drugs?
    Low dose aspirin

  4. What options are there for lowering lipid levels?
    • Statins
    • Fibrates
    • Bile acid sequestrant
    • Nicotinic acid
  5. What are the cholesterol targets when prescribing lipid-lowering drugs?
    Total cholesterol <4mmol/l

    LDL cholesterol <2mmol/l
  6. How do statins work?
    Competitively inhibits HMG CoA in the liver (cholesterol synthesis pathway)
  7. When should you be cautious when prescribing statins?
    Ensure hypothyroidism is well-managed

    History of liver disease or alcoholism (measure LFTs at 3/12 and 12/12)

    Risj of myopathy or rhabdomyolysis

    Pregnancy and breast-feeding
  8. What are the side effects of statins?
    Myalgia, Myopathy, Myositis, Rhabdomyolysis

    Rarely: hepatitis, jaundice, pancreatitis and liver failure

    GI disturbance, Sleep affected, headaches, dizziness
  9. What counsel should you give a patient before they start statins?
    To report unexplained muscle pain, tenderness or weakness promptly
  10. Give examples of statins
    Atorvastatin (lipitor)

Card Set
Cholesterol-lowering drugs
lipid-regulating drugs
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