Hypolipidemic DrugsHypolipidemic Drugs

Statins:Statins:Simvastatin, Atorvastatin, Simvastatin, Atorvastatin,

Bile Acid BindingBile Acid Binding Resins:Resins: Cholestyramine, Colestipol, Cholestyramine, Colestipol,

Nicotinic acidNicotinic acid NiacinNiacin Fibric Acid Derivatives Fibric Acid Derivatives GemfibrozilGemfibrozil and Fenofibrateand FenofibrateEzetimibeEzetimibe

Statins

HMG-CoA Reductase InhibitorsHMG-CoA Reductase Inhibitors

HMG-CoA HMG-CoA Cholesterol Cholesterol bile bile acidsacids

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HMG-CoA Reductase

Statins

StatinsStatinsSide Effects:

Elevations of serum aminotransferase level ( liver enzymes)

Myositis (muscle pain), rhabdomyolysis, myoglobinemia, acute renal failure

Headache, nausea, bowel upset

Uses of statins Uses of statins

Familial hypercholestrolemiaFamilial hypercholestrolemia

Familial combined hyperlipidemia Familial combined hyperlipidemia

EZETIMIBE EZETIMIBE

Decreases GI Uptake of cholesterolSynergistic action with statin

Statin decreased synthesis of cholesterol in liver +Ezetimibe absorption from intestine

NiacinNiacin

Side EffectsSide Effects

FlushingFlushing, tachycardia, dry skin, , tachycardia, dry skin, nausea, nausea,

Fibric Acid DerivativesFibric Acid Derivatives

Gemfibrozil and FenofibrateGemfibrozil and Fenofibrate

Lower triglycerides and raise Lower triglycerides and raise HDL HDL

Fibric Acid Derivatives Fibric Acid Derivatives

Side EffectsSide EffectsRash, GI symptoms, Rash, GI symptoms, myopathy,myopathy, high high

aminotransferaseaminotransferase

Sites of Action for HypolipidemicsSites of Action for Hypolipidemics