Antihyperlipidemic+or+Dyslipidemic+Drugs



 (Antihyperlipidemic Drugs/ Dyslipidemic Drugs/Hypolipidemic Drugs)

Definition: Antihyperlipidemic drugs are drugs that promotes a reduction of lipid levels in the blood or acts to prevent or counteract the accumulation of lipids in the blood.Hypolipidemic agents, or antihyperlipidemic agents, are a diverse group of [|pharmaceuticals][|hyperlipidemias]. They are called that are used in the treatment of lipid-lowering drugs (LLD) or agents.  =CLASS = There are several classes of hypolipidemic drugs. They may differ in both their impact on the cholesterol profile and adverse effects. For example, some may lower the "bad cholesterol" [|low density lipoprotein] (LDL) more so than others, while others may preferentially increase [|high density lipoprotein] (HDL), "the good cholesterol". Clinically, the choice of an agent will depend on the patient's [|cholesterol profile], [|cardiovascular risk] , and the [|liver] and [|kidney] functions of the patient, evaluated against the balancing of risks and benefits of the medications. In the United States, this is guided by the [|evidence-based] guideline from the [|National Cholesterol Education Program] (NCEP) Adult Treatment Panel III (ATPIII).


 * [|__statins__] are particularly well-suited for lowering LDL, the cholesterol with the strongest links to cardiovascular diseases. In studies using standard doses, statins have been found to lower LDL-C by 18% to 55%, depending on the specific statin being used. There is a risk of severe muscle damage ( [|myopathy] & [|rhabdomyolysis] ) with statins.
 * [|__fibrates__] are indicated for [|hypertriglyceridemia] . Fibrates typically lower triglycerides by 20% to 50%. Level of the good cholesterol HDL is also increased. Fibrates may decrease LDL, though generally to a lesser degree than statins. Similar to statins, there is a risk of severe muscle damage ( [|myopathy] & [|rhabdomyolysis] ) with fibrates.
 * [|__niacin__] __,__ like fibrates, is also well-suited for lowering triglycerides by 20-50%. It may also lower LDL by 5-25% and increase HDL by 15-35%. Niacin may cause [|hyperglycemia], and may also cause [|liver damage].
 * [|__bile acid sequestrants__] (resins) are particularly effective for lowering LDL-C by sequestering the cholesterol-containing bile acids released into the intestine and preventing their reabsorption from the intestine. It decreases LDL by 15-30% and raises HDL by 3-5%. It has little effect on triglycerides but can cause a slight increase. Bile acid sequestrants may cause gastrointestinal problems, and may also reduce the absorption of other drugs and vitamins from the gut.
 * [|__ezetimibe__] (Zetia) is a selective inhibitor of dietary cholesterol absorption.
 * [|__phytosterols__] may be found naturally in plants. Similar to ezetimibe, phytosterols reduce the absorption of cholesterol in the gut. Hence, they are most effective when consumed with meals. However, the precise mechanism of action of phytosterols differs from ezetimibe.
 * [|__Orlistat__] (Xenical): Its primary function is to prevent the absorption of about 30%of fats from the human diet; thereby reducing caloric intake (a drug designed to treat [|obesity] ) is by inhibiting [|Pancreatic lipase] - an enzyme that breaks down [|triglycerides] in the intestine.

=**Indications: **=
 * Treatment of hypercholesterolaemias, particularly in type IIa & IIb hyperlipoproteinaemias.
 * Hyperlipidaemias
 * Lipid metabolism disorders that fail to be adequately controlled by dietary measures, increased physical activity &/or wt reduction
 * Lipid metabolism disorders that are due to an underlying illness & persist despite adequate treatment of the underlying condition.
 * Adjunct to diet for treatment of hypercholesterolemia. High-risk CHD w/ or w/o hypercholesterolemia eg diabetes, history of stroke or other cerebrovascular disease, peripheral vessel disease or w/ existing CHD to reduce the risk of CV death, major CV events, eg stroke & angina pectoris.
 * Reduce LDL-cholesterol & triglycerides. Increase HDL-cholesterol in the treatment of hyperlipidemia, including hypercholesterolemia & combined hyperlipidemia. Also as prophylaxis in patients w/ ischemic heart disease.

= = ** CLASS ** -statin -acute liver disease -pregnancy -lactation **common side effects** =abdominal pain =dyspepsia =nausea =headache =skin rashes 1. Altovast® [film-coated tab] 2. Lipitin-S® [film-coated tab] 3.Pharex Simvastatin ® [tab] ** CLASS ** -fibrate **contraindication** -preexisting gallbladder dysfunction -pregnancy and lactation -severe renal dysfunction **common side effects** =abdominal pain =headache =nausea =constipation =rhinitis 1. Fibrafen® [cap] 2. Lipanthyl® [67M cap] 3. Lipilfen® [cap]
 * =__ Simvastatin __=
 * contraindication**
 * =__** Fenofibra te **__=

**CLASS** -lipstatin -chronic malabsorption syndrome -cholistasis -Reduced gallbladder function **common side effects** =oily spotting =flatus with discharge =fecal urgency =fecal incontinence =increased defecation 1. Lesofat® [cap] 2. Xenical® [cap]
 * =** Orlistat **=
 * contraindication**

** CLASS - ** pyridine **contraindication** -significant or unexplained hepatic dysfunction -active peptic ulcer -arterial bleeding =** headache =abdominal pain =diarrheaa =dyspepsia =chills 1.Tredaptive® [tab] 2.Niaspan® (tab)
 * =** Nicotinic acid 1 g, laropiprant 20 mg **=
 * common side effects

**CLASS** -fibrates -**hepatic or severe renal dysfunction -primary biliary cirrhosis -gallbladder disease **common side effects** =dyspepsia =abdominal pain =nausea =vomiting =diarrhea 1.Lipizile ® [cap] 2.Lopid® [cap] [tab] 3. Lipison ®[tab]
 * =** Gemifibrozil **=
 * contraindication

**CLASS** -fibrates -**severe hepatic or renal impairment -pregnancy & lactation -those who have galactose intolerance **common side effects** =vertigo =rashes =myalgia =GIT disturbances 1.Modalim ®[tab]
 * =** Ciprofibrate **=
 * contraindication
 * =** headache

** CLASS -statins** **contraindication** -pregnancy -lactation **common side effects** =headache =skin rashes =blurred vision =nausea =dyspepsia 1.International Apex Lovastatin ®[tab] 2.Advicor ®[tab] 3.Altoprev ®[tab] **CLASS** -statins -pregnancy -lactation -active liver disease or unexplained elevation of transaminases **common side effects** =flatulence =myalgia =headache =abdominal pain =diarrhea 1.Ezetrol ®[tab] 2.Vytorin ®[tab] ==== ** MEMBERS: AB ABAAG, JOSEPHUS ** ====
 * = Lovastatin =
 * -**active liver disease
 * =** Ezetimibe **=
 * contraindication**

** LOYOSEN, EMOGINE **
**90/100 VERY GOOD!**