Miscellaneous lipid-lowering medications
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Miscellaneous lipid-lowering medications
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Miscellaneous lipid-lowering medications
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Lipid-lowering medications work to decrease levels of cholesterol and triglycerides in the body.
Several medications fall outside the more commonly used classes like statins and fibrates, so in this video, we're going to discuss the bile acid resins, niacin or vitamin B3, ezetimibe, and the PCSK9 inhibitors.
Although it’s got a bad reputation, cholesterol is actually a critical component of our cells and is used to build the cell membrane.
It also has other uses like the synthesis of: steroid hormones, vitamin D, and bile.
Normally, we get our cholesterol from the food we eat, but it can also be synthesized by the liver.
So when we eat a box of chili fries, the fats and cholesterol are absorbed in the small intestine.
However, they’re 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 fats 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 adipose tissue and the liver.
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)
- "Cholestyramine" Can Med Assoc J (1971)
- "Cholestyramine treatment of healthy humans rapidly induces transient hypertriglyceridemia when treatment is initiated" American Journal of Physiology-Endocrinology and Metabolism (2017)
- "Bile Acid Malabsorption in Chronic Diarrhea: Pathophysiology and Treatment" Canadian Journal of Gastroenterology (2013)
- "Statins for children with familial hypercholesterolemia" Cochrane Database of Systematic Reviews (2017)
- "Ezetimibe for the prevention of cardiovascular disease and all-cause mortality events" Cochrane Database of Systematic Reviews (2018)
- "Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease" New England Journal of Medicine (2017)
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