B4 Pharm Exam 1
How hyperlipidemia leads to heart failure - hyperlip --> athero --> CHD (ie. angina, MI)
and/or HTN --> heart failure
Classes of
... [Show More] Antihyperlipidemic Drugs - - HMG-CoA reductase inhibs (statins)
- Bile acid sequestrants
- Chol absorp inhibs
- Fibrates
- Niacin
- Others incl PCSK9 inhibs, HDL elevs, HoFH
Lipoprotein - transp form of lipids made up of lipids+prots since lipids insol in plasma
Chylomicrons - lipoprot synth in intest made of dietary (exog) TGs+chol; most imp
apoprot = ApoB-48
VLDL - lipoprot synth in liver made up of endog/hep TGs; most imp apoprot = ApoB-100
IDL - lipoprot synth from VLDL catab made up of chol esters+endog TGs; most imp
apoprot = ApoB-100
LDL - lipoprot synth from VLDL catab expr in liver+intest, made up of chol esters; most
imp apoprot = ApoB-100
HDL - lipoprot synt in intest, liver, plasma made up of phospholips+chol esters; most
imp apoprot = ApoA
LDL structure - core of chol esters + outer layer of ApoB-100, phospholipids, free chol
mols
Relationship of Lipoprotein Size & Density - largest lipoprot (chylomicrons) has lowest
density; highest dens = Lp(a) & HDL
Exogenous Pathway of Lipid Metabolism - 1). Diet TGs+chol incorp into large chylomic
lipoprots
2). Chylomics hydr by LPL on endoth surf adip+musc, cleaving FAs from TGs
3). Chylomic enters circ as predom chol (chylomic remnant)
4). Chylomic remnant into liver by rec-med endocyt
Endogenous Pathway of Lipid Metabolism - 1). Liver secr TGs+chol in VLDL form,
metab by LPL --> IDL
2). Chol dens in IDL incr until LDL form
3). LDL into liver/periph tiss by LDLR or accum in BVs (athero)
4). HDL prom chol rem from periph cells, tx to apoprot --> deliv back to liver for
metab/excr
B4 Pharm Exam 1
Pathogenesis of Atherosclerosis - LDL migr into BV intima, bind proteoglycans -->
oxid/glycosylated --> aldehyde intermeds fragmenting ApoB-100 - endoth dam --> mac invasion --> endoth+mac GFs stim sm musc migr to tun int (sm
musc hyperpl) --> oxLDL accum in macs (foam cells)+musc cells --> coll+el fibs into CT
matrix forming subendoth fibr plaque
Role of Hyperlipidemia in CVD - major CHD RF incl ac MI, ac+chron IHD, angina
pectoris, athero CVD
- gen+EVRal facs incr serum lipoprot lev
- athero = predom MI cause by turb bl flow around cor art plaque prod occl thrombus
Antihyperlipidemic Drugs for Treatment of Hypercholesterolemia - - HMG-CoA
Reductase Inhibs = Atorvastatin, Lovastatin, Pravastatin, Simvastatin, Fluvastatin,
Pitavastatin, Rosuvastatin
- Bile Acid Sequestrants = Colestipol, Cholestyramine, Colesevelam
- Chol Absorp Inhibs = Ezetimibe
Antihyperlipidemic Drugs for Treatment of HyperTG - - Fibrates = Gemfibrozil,
Fenofibrate, Fenofibric Acid
- Niacin
Statins in order from least LDL-lowering to greatest LDL-lowering - - Fluvastatin
- Lovastatin
- Pravastatin
- Simvastatin
- Pitavastatin
- Atorvastatin
- Rosuvastatin [Show Less]