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HMG-CoA Inhibitors (Statins) - Drugs
In order of most potent to least potent: Rosuvastatin (Crestor 5-40), Atorvastatin (Lipitor 10-80), Simvastatin (Zocor 5-80), Pitavastatin (Livalo 1-4), Pravastatin (Pravachol 10-80), Lovastatin/ER (Mevacor 10-80/Altoprev 10-60), Fluvastatin (Lescol 20-80)
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HMG-CoA Inhibitors (Statins) - Drug Equivalents
Rosuvastin 10 = Atorvastatin 20 = Simvastatin 40 = Pravastatin/Lovastatin 80
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HMG-CoA Inhibitors (Statins) - Mechanism
inhibits the rate - limiting step of de novo synthesis of cholesterol
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HMG-CoA Inhibitors (Statins) - Adverse Effects
myalgia, LFT elevation, CK elevation, hepatic failure, rhabdomyolysis
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HMG-CoA Inhibitors (Statins) - Monitor
LFTs, S/Sx of myalgia
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HMG-CoA Inhibitors (Statins) - Targets
LDL (reduce as high as 63%), little effect of HDL
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Cholesterol Absorption Inhibitor - Drugs
Ezetimibe (Zetiia 10)
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Cholesterol Absorption Inhibitor - Mechanism
Inhibits cholesterol absorption at the brush border in the small intestine
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Cholesterol Absorption Inhibitor - Adverse Effects
hepatitis, cholecystitis, cholelithiasis, abdominal pain, diarrhea
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Cholesterol Absorption Inhibitor - Target
LDL (reduce by ~18%)
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Niacin - drug in own class
Niacin - Niaspan (500-2000)
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Niacin - Mechanism
enhances lipoprotein lipase activity, inhibits lipolysis in adipose tissue, decreases VLDL production
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Niacin - Adverse Effects
Flushing, abdominal pain, LFT elevation, N/V, hepatic failure, hyperglycemia, hyperuricemia
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Niacin - Monitor
LFTs, glucose, uric acid
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Niacin - Target
Raises HDL
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Fibric Acid Derivatives - Drugs
Gemfibrozil (Lopid 1200), Fenofibrate (Fenoglide 40-120, Lipofen 50-150, Lofibra Tabs 54-160, Tricor 48-145, Triglide 50-160), Fenofibrate Micronized (Antara 43-130, Lofibra Caps 67-200), Fenofibric Acid (Trilipix 45-135)
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Fibric Acid Derivatives - Mechanism
Inhibits lipolysis in adipose tissue, decreases production and increases clearance of apoB, enhances lipoprotein lipase activity
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Fibric Acid Derivatives - Adverse Effects
dyspepsia, abdominal pain, N/V, diarrhea, elevated LFTs, cholelithiasis, myopathy, thrombocytopenia, anemia
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Fibric Acid Derivatives - Monitor
SCr, LFTs, CBC
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Fibric Acid Derivatives - Target
lower TG, Raise HDL; upregulate protein lipase - affects VLDL production in liver
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Bile Acid Sequestran - Drugs
Colestipol (Colestid 2-16), Colesevelam (Welchol 2500-4375)
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Bile Acid Sequestran - Mechanism
binds intestinal bile acids preventing enterohepatic
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Bile Acid Sequestran - Adverse Effects
esophageal obstruction, bowel obstruction, fecal impaction, dysphagia, constipation, dyspepsia
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Bile Acid Sequestran - Target
LDL (reduce by 15-18%)
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Bumblebee Tuna - Drugs
omega 3 fatty acids (Lovaza 4)
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Bumblebee Tuna - Mechanism
decreases hepatic triglyceride synthesis
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Bumblebee Tuna - Adverse Effects
anaphylaxis, dyspepsia, eructation, elevated LFTs
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Bumblebee Tuna - Monitor
LFTs
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Bumblebee Tuna -Target
TG (reduce by 45%) and HDL (raise by 9%)
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