Card Set Information
Lack of or faulty LDL receptors leading to increased LDL crculating in blood that never gets taken back to liver. The Apo B protein starts interacting at the vessel wall leading to atherosclerosis.
Cholesterol - 700-1000
Triglycerides - normal
Xanthelasmas, corneal arcus, xanthomas
Lipoprotein lipase deficiency - associated with metabolic syndrome
Increased LDL and Apo B.
Mixed elavation in triglycerides & LDLs with low HDL
Responds to diet & exercise but most need meds
At increased risk for this if pt has familial hypertriglyceridemia.
Signs - abdominal pain, hepatosplenomegaly, eruptive xanthomas, pancreatitis, lipemia retinalis, paresthesias.
lowers LDL, increased HDL & lowers triglycerides
Gold standard for cholesterol trx
Can get rhabdomyolysis so if pt c/o achy joints, take them off.
Nicotinic acid - Niacin
Vitamin B3 - lowers triglycerides, increases HDL and modestly lowers LDL.
Can get flushing, intensity can be diminished with aspirin
Can be used w/ simvastatin to induce plaque regression
Fibrates - Gemfibrizol, Fenofibrate
Effective at lowering triglycerides in pts w/ very high levels who are at risk for pancreatitis, esp. in those who can't tolerate Niacin. Tends to increase LDLs in pts.
Monitor CPKs and LFTs
Cholesterol absorption inhibitors - Ezetimibe
Lowers both LDL and triglycerides with minimal effects on HDL. Can be used in combination with statin to further lower LDL.
Can get hepatitis, abdominal pain, arthralgia
Monitor LFTs and CPK
Bile acid sequestrants - cholestyramine
Lower LDL & decrease cardiovascular event rates. Especially effective when combined with statins
GI side effects, decreased absorption of some drugs (BC)
Fiber (metamucil), fish oil, diet & exercise.