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Bile Acid Sequestrants
Cholestyramine (Questran)
- Combine with bile acid in small intestines to make insoluable complexes which get excreted. Lowers LDL and cholesterol
- Bloating, belching, constipation, nausea, headache.
- Not for use if biliary obstruction. Should be taken before meals. Most other meds must be take 1 hour before or 4-6 hours after this med. Decrease absorption of fat soluable vitamins (ADEK), thiazides, dig, warfarin, thyroid hormones and corticosteroids.
- Binds bile acids in intestine allowing excretion in feces
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HMG-CoA Redictase Inhibitors
Atorvastatin (Lipitior)
- Decrease rate of cholesterol production by inhibiting HMG-CoA reductase.
- Muscle pain, blurred vision, opthalmoplegia, insomnia, increased lever enzymes.
- Pregnancy Cat X. Not with lever disease. Usually taken in the evening. Increased risk of rhabdomyolysis with Erythromycin, cyclosporine, gemfibrozil, niacin, or antifungals. Toxicity with Dig or Warfarin. Increased toxicity with Grapefruit juice.
- Hyperlipidemias to lower LDL and increase HDL.
- Adjunct to diet and exercise. Slows progression of CAD. Prevents MI.
- Inhibits MHG-CoA causing a decrease in serum cholesterol
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Cholesterol Absorption Inhibitor
ezetimibe (Zetia)
- Decrease absorption of dietary cholesterol from the small intestines.
- Mild abdominal pain and diarrhea. No bloating or flatulence.
- Effects in pregnancy unknown. Well absorbed after oral administration. Elevated levels if with cholestyramine, fenofibrate, gemfibrozil, or antacids. Increased risk of toxicity with cyclosporine. Risk of cholelithiasis with fibrates. Increase Warfarin levels.
- Decrease amount of cholesterol absorbed from food.
- Used with Diatary treatment to lower LDL cholesterol, total cholesterol, triglycerides.
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