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ANTILIPEMIC DRUGS (FABRIC ACID DERIVATIVES (Indications (To increase high…

- - - - It is used along with proper diet to help lower cholesterol and fats. It is used to treat heterozygous familial hypercholesterolemia. It may also interfere with hormone production and may also slow progress of heart disease.
  - - - Simvastatin is a lipid lowering agent that derived synthetically from fermentations of aspergillus terreus. It is a potent competitive inhibitor of 3-hydroxyl 3-methylglutaryl co enzyme a reductase which is the rate limiting enzyme in cholesterol biosynthesis. Due to the induction of hepatic LDL receptors it increases breakdown of LDL cholesterol
  - - - Simvastatins
  - - - CONTRAINDICATIONS
        
        Alciholism, haemorrhage of the brain, renal impairment, recent operation, loss of memory, high blood sugar, pregnancy, muscle pain or tenderness increases creatine kinase and abnormal liver function test.
      - SIDE EFFECTS
        
        Heartburn, gas bloating, stomach pains, headache, diarrhoea, joint pain, constipation, skin rash, sleep problems, mild memory problems or confusion and cold symptomps such as sneezing or sores throat, fever, painful urination, weight gain and polyphagia jaundice.
      - ROUTE OF ADMINISTRATION
        
        It is taken orally either by liquid or tablet once in the evening. may be taken with food and shake the bottle well for 20 seconds before each dose
      - STORAGE CONDITIONS
        
        Store at room temperature and do not refrigerate. Store in a dry place and protect from heat.
- - - - It is to alter lipid properties. It involves several actions including partial inhibition of release of free fatty acid from adipose tissue and increased lipoprotein lipase activity which may increase the rate if chylomicron tryglyceride removal from plasma. Niacin decreases the rate of hepatic synthesis of very low density lipoproteins and does not appear to effect faecal excretion of fats, steroids or bile acids
  - - - It is indicated to reduce elevated triglyceride, low density lipoproteins and apo B. It increases high density lipoproteins in patients with primary hyperlipidemia and mixed dyslipidemia. patients with myocardial infarction for reduction of recurrent non-fatal myocardial infarction.
  - - - Nicotinic acid
  - - - CONTRAINDICATIONS
        
        Liver disease, active peptic ulcer disease, arterial bleeding and hypersensitivity to niacin
      - SIDE EFFECTS
        
        Rah on the skin, diarrhoea, nausea and vomiting, increased cough and pruiritus, tachycardia, palpitation, shortness of breath, flushing of the skin.
      - ROUTE OF ADMINISTRATION
        
        It is administered orally or parenterally. It should be administered after meals in order to increase its bioavailability.
      - STORAGE CONDITIONS
- - - - Mechanism of action
        
        Forms complex with bile acids that is not absorbed through intestines
        
        Inhibits enterohepatic reuptake of intestinal bile salts and this in turn increases fecal loss of bile salts-bound and consequently reduces serum cholesterol in patients with primary hypercholesterolemia.
      - Indications
        
        Post-vagotomy diarrhea
        
        Clostridium difficile infections
        
        Pruritus that occurs due to liver failure
        
        Diarrhea results from bile acid melabsorption
      - Contra indications
        
        Complete biliary obstruction
        
        Biliary cirrhosis
        
        Hypertriglyceridemia, hemorrhoids
        
        Hypersensitivity to bile- sequestering resins
      - Side effects
        
        Belching
        
        Heart burn
        
        Malabsorption of fat-soluble vitamins
        
        Pancreatitis
        
        Duodenal ulcer bleeding
      - Storage
        
        Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light, keep from freezing
      - Route of administration
        
        Powder for oral suspension, mix with fluids and take before or meals