Lipid-lowering medications: Fibrates
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Lipid-lowering medications: Fibrates
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
Hypertension: Clinical (To be retired)
Hypercholesterolemia: Clinical (To be retired)
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Dermatology and plastic surgery
Hypersensitivity skin reactions: Clinical (To be retired)
Eczematous rashes: Clinical (To be retired)
Papulosquamous skin disorders: Clinical (To be retired)
Alopecia: Clinical (To be retired)
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Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Endocrinology and ENT (Otolaryngology)
Diabetes mellitus: Clinical (To be retired)
Hyperthyroidism: Clinical (To be retired)
Hypothyroidism and thyroiditis: Clinical (To be retired)
Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
Hypothyroidism medications
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Gastroenterology and general surgery
Gastroesophageal reflux disease (GERD): Clinical (To be retired)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Diarrhea: Clinical (To be retired)
Malabsorption: Clinical (To be retired)
Colorectal cancer: Clinical (To be retired)
Diverticular disease: Clinical (To be retired)
Anal conditions: Clinical (To be retired)
Cirrhosis: Clinical (To be retired)
Breast cancer: Clinical (To be retired)
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Hematology and oncology
Anemia: Clinical (To be retired)
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Infectious diseases
Pneumonia: Clinical (To be retired)
Urinary tract infections: Clinical (To be retired)
Skin and soft tissue infections: Clinical (To be retired)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anti-mite and louse medications
Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Non-biologic disease modifying anti-rheumatic drugs (DMARDs)
Osteoporosis medications
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Lipid-lowering medications: Fibrates
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Bezafibrate p. 327
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Content Reviewers
Yifan Xiao, MDContributors
Evan Debevec-McKenney
Fibrates are a group of lipid-lowering medications, along with statins and niacin.
These medications are very effective at lowering triglyceride levels in the blood, but are less effective at controlling cholesterol.
Now, triglycerides make up most of your body fat, and they consist of a glycerol and 3 fatty acids.
So when we eat a box of chili fries, the fatty acids and cholesterol are absorbed into the cells in the small intestine.
The fatty acids are then converted into triglycerides.
However, triglycerides and cholesterol are not water soluble, so they can’t travel freely in the blood. To fix this, our body makes “shipping boxes” called lipoproteins.
These containers consist of a shell made of phospholipids and protein tags that act as instructions for their destination.
So after absorption, the small intestinal cells package the triglycerides and cholesterol into the largest, but least dense lipoproteins, called chylomicrons.
These are released into the lymphatic system and then enter the bloodstream via the subclavian vein. Then, they travel through the blood to reach the liver and other tissues in the body.
Now in the blood vessels near these tissues, we have an enzyme called lipoprotein lipase, which can break down triglycerides into fatty acids.
Cells in the nearby tissue can then use these fatty acids to generate ATP.
Adipose tissue can synthesize a lot of lipoprotein lipases, which means they have access to a lot of fatty acids.
Now, instead of using the fatty acids for energy, they pick them up, convert them back into triglycerides, and store them for later use.
Sources
- "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
- "Rang and Dale's Pharmacology" Elsevier (2019)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "PPAR Agonists and Metabolic Syndrome: An Established Role?" International Journal of Molecular Sciences (2018)
- "Fibrates for primary prevention of cardiovascular disease events" Cochrane Database of Systematic Reviews (2016)
- "PPAR-Induced Fatty Acid Oxidation in T Cells Increases the Number of Tumor-Reactive CD8+ T Cells and Facilitates Anti–PD-1 Therapy" Cancer Immunology Research (2018)
- "Use of fenofibrate on cardiovascular outcomes in statin users with metabolic syndrome: propensity matched cohort study" BMJ (2019)
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