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Lesson 11 - Coggle Diagram

- - - - statins
        
        ezetimibe if lipids still not at target
  - - - statins
        
        ezetimibe
        
        fibrates or niacin if lipid still not at target
  - - - TG more than 4.5mmol/L or 400mg/dL
        
        fibrates
        
        omega 3 fish oils or niacin
  - - - TG more than 10 mmol/L or 900mg/dL
        
        fibrates and omega 3 fish oils
        
        niacin if TG more than 4.5mmol/L or 400mg/dL
  - - - Higher LDL cholesterol, lower HDL cholesterol = higher risk of ischemic heart disease
- - - - apoC2 and apoC3 are needed to synthesize VLDL
    - - Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear receptor supergene family that regulates lipid metabolism. Fibrate diffuses across the cell membrane. It will bind and activate PPARa receptors which function as ligand-activated transcription factors. Activated PPARs regulate the expression of genes to code for proteins which are involved in lipoprotein structure and function.
        
        Increase transcription of gene for lipoprotein lipase -> increase synthesis of lipoprotein lipase -> decrease TG from VLDL -> VLDL will stop circulating around tissue
        
        Increase transcription of gene for apoA1 and apoA2 -> increase HDL levels
- - - - To produce more bile acids, the liver converts more cholesterol into bile acids, which lowers the level of cholesterol in the blood
        
        Decreased LDL levels
- - - - Lowers down its remenant, subsequent VLDL and lastly LDL
- - - - Prolog bleeding time, anti-inflammatory effect and reduction of plasma fibrinogen