1 / 17

Lipid lowering agents

Lipid lowering agents. By: Dr Israa Omar MBBS, MRCP, MSc pharmacology. HMG-CoA reductase inhibitors. Reduces plasma concentration of LDL- Cholestrol by more than 30%. Also cause a small reduction on plasma TGA and a small increase in plasma HDL

ziv
Download Presentation

Lipid lowering agents

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Lipid lowering agents By: Dr Israa Omar MBBS, MRCP, MSc pharmacology

  2. HMG-CoA reductase inhibitors • Reduces plasma concentration of LDL-Cholestrol by more than 30%. • Also cause a small reduction on plasma TGA and a small increase in plasma HDL • (statins)include simvastatin, pravastatin, atorvastatin. REDUCE THE RISK OF CORONARY RTERY DISEASE BY 42%

  3. MOA • Suppress HMG-COA reductase in the liver and therefore depress the production of cholesterol, which leads to increase synthesis of LDL receptors . • As a result, the clearance of LDL is enhanced

  4. Clinical uses • To treat patient with hyperlipidemia

  5. Adverse effects • GIT disturbance • Insomnia • Rash • More serious adverse effects (myositis, hepatitis, angio-oedema )

  6. fibrates • Include clofibrate, gemofibrate, fenofibrate. • Mainly reduce VLDL and hence triglyceride . • Also reduce LDL and increase HDL • Gemofibrozil has been shown to reduce coronary heart disease by one third compared to the placebo in male patients with primary hyperlipidaemia

  7. MOA • Stimulate the lipoprotien lipase in the peripheral tissues, and hence, increase hydrolysis of TGA in chylomicron and VLDL particles. • Also probably reduce hepatic VLDL production and increase LDL uptake

  8. Clinical uses • To treat patients with mixed hyperlipidemia (raised TGA and raised cholestrol)

  9. Adverse effects • Myositis which can cause myoglobinuria and acute renal failure • Clofibrate can cause gallstone so its use is limited to patients who have had cholcystomy

  10. Bile acid-binding resins • Cholestyramine and Colestipol • They reduce the plasma concentration of LDL-cholestrol by more than 10%

  11. MOA • They sequester the bile in the intestine and prevent their reabsorption and entero-hepatic recirculation. • This lead to increase expression of LDL receptors in the liver and hence removal of LDL from the blood

  12. Clinical uses • Used in addition to statins to treat hyperlipidemia

  13. Adverse effect • N/V, abdominal pain , bloating, constipation or diarrhea are the commonest adverse effects • They interfere with absorption of fat- soluble vitamins and drugs like Digoxin and Warfarin

  14. Nicotinic acid derivatives • Mechanism of action is poorly understood • It is a water soluble vitamin • Inhibit the production of hepatic triglyceride and VLDL secretion with reduction of in TGA and LDL and increase HDL • It increase the blood sugar and causes flushing of the face an effect that can be reduced by taking Aspirin • Modified release prepartion are well tolerated

  15. Ezetimibe • Specifically inhibits absorption of cholesterol by blocking NPC1L1 in the brush border without affecting the absorption of bile salts or fat soluble vitamins • Combined with statins to treat patients with severe dyslipidemia • Generally well tolerated but can cause diarrhea, headache, rash and angioedema also reported

  16. Thank you

  17. Reference • RANGE AND DALE ,PHARMACOLOGY

More Related