DRUGS FOR DYSLIPIDEMIA.pdf

3/27/24, 12:10 PM Platform | Study Fetch DRUGS FOR DYSLIPIDEMIA Overview of Dyslipidemia: - Lipid sources are endogenous (produced by the body) and dietary (from food) - Cholesterol is a component of cell membranes and is essential (pg. 174) - Lipoproteins vary in density, with HDL being "good chole...

3/27/24, 12:10 PM Platform | Study Fetch DRUGS FOR DYSLIPIDEMIA Overview of Dyslipidemia: - Lipid sources are endogenous (produced by the body) and dietary (from food) - Cholesterol is a component of cell membranes and is essential (pg. 174) - Lipoproteins vary in density, with HDL being "good cholesterol" and LDL being "bad cholesterol", and VLDL being mostly triglycerides (pg. 174) - Term to know: Atherosclerotic Cardiovascular Disease (ASCVD) (pg. 174) - ASCVD Risk Assessment is now based on the absolute risk of developing clinical coronary disease over the next 10 years (pg. 174) - Pediatric patients are a growing concern for cholesterol screening (pg. 174) - No longer targeting specific cholesterol goals - patients benefit from cholesterol-lowering therapy even if lab values don't improve (pg. 174) - Management includes Therapeutic Lifestyle Changes (TLC), especially exercise, smoking cessation, and weight control, but still give drugs (pg. 174) HMG-CoA Reductase Inhibitors (Statins): - Prototype: atorvastatin (pg. 178) - Oral medication, one of the most widely used drugs in the U.S. - Used to treat hypercholesterolemia and to prevent cardiovascular events (MI, stroke, angina) even for patients with diabetes without high cholesterol (pg. 178) - Adverse effects are mild, but can include myopathy (injury to muscle tissue), rhabdomyolysis, hepatotoxicity, and cataracts (pg. 178) - Other common drugs: lovastatin and simvastatin (pg. 178) Bile Acid Sequestrants: - Prototype: cholestyramine (pg. 183) - Reduces LDL, used in conjunction with statins - Binds bile acids in the intestine so they are excreted in the stool (pg. 183) Fibric Acid Derivatives (Fibrates): https://www.studyfetch.com/platform/studyset/660460b18664df1756aa17eb/material/660460e917b4a65a7ca01ef4/document 1/3 3/27/24, 12:10 PM Platform | Study Fetch - Prototype: fenofibrate (pg. 184) - Decreases triglycerides, raises HDL - Only adverse effect is GI discomfort and diarrhea (pg. 184) Cholesterol Absorption Inhibitor: - Prototype: ezetimibe (pg. 186) - Inhibits absorption of cholesterol in the small intestine (pg. 186) Miscellaneous: - PCSK9 Inhibitors: alirocumab, significantly lowers LDL (pg. 187) - Niacin (nicotinic acid): a vitamin that decreases LDL and increases HDL, used as an adjunct but watch for liver toxicity if taking with other lipid lowering meds (pg. 187-188) DRUGS FOR COAGULATION DISORDERS Overview of Coagulation: - Various factors, platelets, and thromboplastin lead to the formation of prothrombin, fibrinogen, and thrombin, which then form fibrin (pg. 188) - Terms to know: Hemostasis (stopping blood loss to form a clot) and Thrombosis (formation of a blood clot) (pg. 188) Anticoagulants (Reduce Formation of Fibrin): - Heparin: Anticoagulant that suppresses fibrin by inactivating thrombin, must be injected (pg. 147) - Low Molecular Weight Heparins (e.g. enoxaparin): Used to prevent post-op thromboembolism when given SQ in low doses, adverse effects include hemorrhage (pg. 188) - Warfarin (Vitamin K antagonist): Oral anticoagulant for home use, produces a Vitamin K deficiency, may have drug interactions, side effects include hemorrhage (pg. 155) - Newer Oral Anticoagulants: Direct thrombin inhibitor (dabigatran), Direct Factor Xa inhibitor (rivaroxaban), lower risk of bleeding compared to warfarin (pg. 157) Antiplatelet Drugs: - Suppress platelet formation in arteries (cf. anticoagulants which prevent thrombosis in veins) https://www.studyfetch.com/platform/studyset/660460b18664df1756aa17eb/material/660460e917b4a65a7ca01ef4/document 2/3 3/27/24, 12:10 PM Platform | Study Fetch - Prototype: clopidogrel, oral medication with adverse effects of pruritis, rash, diarrhea, less likely to cause hemorrhage (pg. 160) - Aspirin low dose: Prevents MI, another MI, and stroke (pg. 160) Thrombolytics/Fibrinolytics: - Remove thrombi that are already formed, all pose serious risk of bleeding - Uses include MI, ischemic stroke, acute pulmonary edema - Prototype: alteplase (tPA), tissue plasminogen activator (pg. 188) HEMATOPOIETIC DISORDERS Erythropoietin (Epoetin Alfa): - Stimulates red blood cell production in bone marrow for patients with cancer, HIV, and anemia (pg. 166) Granulocyte Colony-Stimulating Factors (Filgrastim): - Stimulate blood cell production by bone marrow for those with neutropenia, to prevent infections, mostly for patients on chemo or bone marrow transplants (pg. 196) DRUGS FOR DEFICIENCY ANEMIAS Iron Deficiency Anemia: - Not getting enough iron, treated with iron supplements like ferrous sulfate - RBCs are microcytic hypochromic - Absorption increased with vitamin C, decreased with antacids (pg. 715) Vitamin B12 Deficiency Anemia: - RBCs are megaloblastic macrocytic anemia, treated with cyanocobalamin (Vitamin B-12) - Often associated with poor diet or chronic alcoholism (pg. 713) Folic Acid Deficiency Anemia: - Treated with folic acid, often associated with poor diet (pg. 713) https://www.studyfetch.com/platform/studyset/660460b18664df1756aa17eb/material/660460e917b4a65a7ca01ef4/document 3/3