Pharm Block 2 ( Hyperlipoproteinemia)

Chylomicrons- Transports Dietary TG from the intestines to the Tissues

VLDL- Transports TG from the liver to the tissues

LDL- Delivers cholesterol to cells. High LDL= High cholesterol.

HDL- Picks up Cholesterol that is accumulating in the blood vessels. (good for the heart)

• Total cholesterol: <200
• LDL: 100
• HDL: 40-50
• Triglycerides: 150

Exogenous- Lipids are picked up in the intestines--> chylomicrons deliver some to the tissues, the rest goes to the liver.

Endogenous- VLDL from the LIVER--> transported to the tissue then returned to the liver.

• RESINS
• STATINS
• NIASIN
• FIBRATES
• EZETIMIBE

• Cholestyramine, Colestipol
• —These bile acid binding resins are neither digested nor absorbed in the gut.they increase fecal excretion of bile salts and cholesterol
• The decrease in cholesterol is also due to up regulation of LDL receptors in liver.

• The body causes a increase in the activity of HMG CoA reductase results in increased cholesterol synthesis and thus increased VLDL secretion – blunting the long term effectiveness of monotherapy
• -Mild increase in triglycerides can be seen.

• 1. Constipation
• 2. Deficiency of fat soluble vitamins- No bile to breakdown the fats

they are drugs for Hyperlipoproteinemia that are HMG CoA reductase Inhibitors (rate limiting step ofcholesterol syn).

• Lovastatin, Sincastatin,
• Atorvastatin (lipitor)- antioxidant effect.
• Rosuvastatin- has a high Potency.
• Fluvastatin
• Cerivastatin
• Pravastatin

Statins work by inhibiting the production of Cholesterol. Cholesterol is needed for Progesterone synthesis. Progesterone is needed for maintenance of pregnancy.

So you should check with the women to see if she is pregant before putting her on them.

• -Increase in LDL receptors expression on the liver--> decrease LDL--> decrease cholesterol.
• -Hepatic synthesis of VLDL is reduced
• -There is an increase in HDL.

• -Endothelial function – increase endothelial NO synthesis
• -Plaque stability – Suppress smooth muscle cell proliferation, inhibit metalloproteinase
• -Anti-inflammatory action
• -Increase activity of paraoxonase - anti-oxidative enzyme
• -Anticoagulation – reduce platelet aggregation

• -Hheadaches
• -Sleep disturbances
• -Hepatotoxicity (esspecially at higher doses) --> Kidney failure.
• -Rhabdomyolysis / myopathy