lipids

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Anonymous
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98834
Filename:
lipids
Updated:
2011-08-29 02:07:28
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lipids
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lipids
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  1. Bile Acid Sequestrants
    • MOA = dec. LDL (inc. TG)
    • Start low dose due to ADR
    • ADR (GI, esophageal obstruction, dec. abs. of fat soluble vitamin and folic acid)
    • **Dec. abs. of warfarin, niacin, digoxin
    • **Admn meds 1-2 hours before meal or 4 hours after BAS
  2. Colesvelam
    Brand - Welchol

    Low potential for Drug interactions
  3. Colestipol
    Brand - Colestid
  4. Cholestyramine
    Brand - Questran
  5. Statins
    • Inhibit HMG-CoA reductase
    • **Dec. LDL
    • Reduce NUMBER of LDL particles (not size)
    • **most efficient at HS
    • **AE: Inc. LFTs, Myopathy/Rhabdomyolsys
  6. Lovastatin
    • Brand - Mevicor
    • IR = take w evening meal (20-80 mg)
    • SR = HS (10-60 mg)

    • CYP 3A4 - Avoid Grapefuit juice, Inc warfarin
    • Gemfibozil - do not exceed 20mg
    • amiodrone & verapamil - no more than 40 mg
  7. Rosuvastatin
    • Brand - Crestor
    • **Hydrophilic
    • *Primary prevention CVD
    • QD 5-40mg
    • Admn anytime w or w/o food
    • **minimal 2c9/2c19 - Inc. Warfarin
  8. Atorvaststin
    • Brand - Lipitor
    • *Admn anytime of day w or w.o food
    • *Do NOT need renal adjustment
    • **CYP 3A4

    • Cyclosporine - dont exceed 10mg/day
    • -azole, mycin, protease inhibitor - dont exceed 20 mg
  9. Simvastatin
    • Brand - Zocor
    • 20-80 mg/evening
    • **CYP 3A4 - Inc warfarin

    • azole, -mycin, Gemofibrozil, cyclosporine - dont exceed 10 mg/day
    • Amiodorone, Verapamil, Dilitiazem - no more than 10 mg
    • amlodipine, ranolazine - no more than 20 mg
  10. Pravastatin
    • Brand - Pravachol
    • **Least Potent**
    • Hydrophilic
    • No CYP450
    • **Admn anytime w or w/o food
  11. Pitavastatin
    • Brand - Liralo
    • **Minimal 2C9/2C8
    • *Admn anytime w or w/o food
    • **CI w cyclosporine
    • Erythromycin - 1mg
    • Rifampin - 2mg
    • Niacin - low dose
  12. Fluvastatin
    • Brand - Lescol
    • **Admn 20-80 at PM - QHS
    • ** NO RENAL ADJUSTMENT
  13. Fibrates
    • MOA - Stimulate PPAR receptor
    • Inc. HDL, Dec. TG
    • AE - Gallstone, Inc. LFT, Myopathy
    • Inc. INR - interact with warfarin

    **Preferrable over Niacin when TG>400
  14. Gemfibrozil
    • Brand - Lopid
    • (Dec. CV in secondary prevention)
    • **600mg BID, 30 min before AM and PM meal

    *Monitor lipid levels, CBC, and LFTs every 3 months (1st yr) then periodically)
  15. Fenofibrate
    • Brand - Tricor, Triglide, Antara, Lofib
    • no regard to meal
    • Monitior LFTs and lipid levels
  16. Ezetimibe
    • Brand - Zetia
    • **CHO absorption Inhibitor (intestinal brush boarder)
    • **Dec. LDL
    • *Not inhibitor/Inducer of CYP 450
  17. Nicotinic Acid
    • MOA - Inc. HDL (Most Potent)
    • **Change LDL to large and fluffy
    • IR = flushing
    • SR = Hepatotoxicity

    ADR - Hyperglycemia, Hyperurincemia
  18. Fish Oil
    • Rx = Lovaza --> 4g/day
    • **Dec. TG
    • AE - GI, Inc. bleeding - caution w ASA/ warfarin

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