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dyslipidemias (treatments (lomitapide (MOA (image, summary: block MTP,…

- - - - MOA
        
        summary: reduces VLDL in days, reduces LDL in weeks, best at increasing HDL
      - side effects
        
        rash and flushing (reduced with aspirin and controlled release), peptic ulcer, gout, hyperglycemia, liver toxicity, atach and afib.
  - - - summary: block MTP, block formation of chylomicrons and VLDL, combination with others for HoFH
    - - hepatotoxicity, contra. in pregnancy, metab. CYP3A4, GI adverse effects due to inhibition of fat absorb.
  - - - MOA
        
        summary: bind PPAPalpha, increase LPL, decrease VLDL (increase Apo C-II, decrease Apo C-III), increase HDL, may increase LDL.
      - side effects
        
        nausea, GI disturbances, liver dysfunction, flu-like, muscle aches (muscle toxicity due to increase in plasma muscle CPK).
  - - - MOA
        
        summary: prevent bile recycling, increase cholesterol breakdown, increase LDL receptors, lower LDL, minimal effect on HDL and VLDL.
      - side effects
        
        GI tract (not absorbed), interfere with fat soluble vitamin absorption (A, D, E, K).
        
        resins only
        
        bloating, cramping, gas, constipation, hyperchloremic acidosis (HDL salts)
  - - - MOA
        
        summary: inhibit HMG-CoA, decrease cholesterol, increase LDLR, increase clearance of LDL (doesn't help with cholesterol intake).
        
        more potent statins like atorvastatin, fluvastatin, rosuvastatin
        
        increase clearance of VLDL
      - side effects
        
        increase liver enzymes, muscle toxicity (CPK), mitochondria toxicity, muscle toxicity with fibrates.
    - - MOA
        
        BASA decrease cholesterol > compensatory effect > increase cholesterol > unsuccessful because statins block synthesis > greater LDLR
  - - - summary: bind NPC1L1, block cholesterol absorption,
  - - - summary: 10 antisense block Apo-B 100 synthesis, lower LDL and VLDL, combination with statins + ezetimibe + plasma apheresis to lower LDL in HoFH (also the only indication).
      - other info: NA salt, administered sc, high plasma protein binding to reduce renal clearance, half-life 1-2 months, no CYP
    - - irritation at injection site, flu-like, increase ALT and liver fat
  - - - MOA
        
        summary: antibodies block PCSK9, prevent lysosome from breaking down receptor, increase LDLR
        
        other info: no clear toxicity, much cheaper, combination with statins = 70% achieve <70 LDL level.