ANTILIPIDEMIC DRUGS PDF

If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Atherosclerosis is the abnormal accumulation of lipids and products resulting from an inflammatory response in the walls of arteries, and is the leading cause of death in the Western world. Heart attacks, angina pectoris, peripheral arterial disease, and strokes are common sequelae of atherosclerosis. In some cases, lowering serum lipid concentrations has been shown to prevent the sequelae of atherosclerosis and decrease mortality in patients with a history of cardiovascular disease and hyperlipidemia. The five drug classes discussed in this chapter Figure 26—1 are used to decrease serum concentrations of lipids in the blood hyperlipidemia and to prevent or reverse associated atherosclerosis, or, in the case of hypertriglyceridemia, prevent pancreatitis. Although the drugs are generally safe and effective, adverse effects include drug—drug interactions and rare toxic reactions in skeletal muscle and the liver.

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If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Atherosclerosis is the abnormal accumulation of lipids and products resulting from an inflammatory response in the walls of arteries, and is the leading cause of death in the Western world.

Heart attacks, angina pectoris, peripheral arterial disease, and strokes are common sequelae of atherosclerosis. In some cases, lowering serum lipid concentrations has been shown to prevent the sequelae of atherosclerosis and decrease mortality in patients with a history of cardiovascular disease and hyperlipidemia. The five drug classes discussed in this chapter Figure 26—1 are used to decrease serum concentrations of lipids in the blood hyperlipidemia and to prevent or reverse associated atherosclerosis, or, in the case of hypertriglyceridemia, prevent pancreatitis.

Although the drugs are generally safe and effective, adverse effects include drug—drug interactions and rare toxic reactions in skeletal muscle and the liver.

The five classes of lipid-lowering drugs. These classes are based on the mechanisms of action of these drugs. Lipids, mainly cholesterol and triglycerides, are transported in human plasma by macromolecular complexes termed lipoproteins.

Lipoproteins are composed of a lipid core surrounded by apolipoproteins that regulate the uptake and off-loading of lipids and interactions with cell membrane receptors. The lipoproteins that are primarily responsible for delivering cholesterol and triglycerides to peripheral tissues originate in the liver and contain a key apoprotein called B The uptake by cells of B—containing lipoproteins can occur by receptor-mediated endocytosis or by scavenger receptors.

Receptor-mediated uptake is a carefully regulated process that protects cells from being overloaded with lipids. In contrast, uptake by scavenger receptors is an unregulated process that can overwhelm the ability of a cell to sequester potentially toxic lipids safely. Macrophages in arterial walls use scavenger receptors to take up circulating lipoproteins, especially particles with apolipoproteins that have been modified by free radicals.

When these macrophages become overloaded with lipids, they are transformed into distressed foam cells that initiate a local inflammatory response. Engorged foam cells, foam cells that have burst, and the products of the inflammatory responses form the core of an atherosclerotic plaque. Whereas plaques can slowly occlude coronary and cerebral vessels, clinical symptoms are more frequently precipitated by rupture of unstable plaques, leading to occlusive thrombi.

Schematic diagram of lipoprotein handling by hepatocytes. The sites of action of several antihyperlipidemic drugs are shown. For identification of abbreviations of the lipoproteins, some drug classes, and additional discussion, see text. Another lipoprotein, high-density lipoprotein HDL , exerts several antiatherogenic effects.

HDL participates in pathways that retrieve cholesterol from the artery wall and inhibit the oxidation of atherogenic lipoproteins. Forgot Password? What is MyAccess? Otherwise it is hidden from view. Forgot Username? About MyAccess If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Sign in via OpenAthens. Sign in via Shibboleth. AccessBiomedical Science. AccessEmergency Medicine. Case Files Collection. Clinical Sports Medicine Collection. Davis AT Collection. Davis PT Collection. Murtagh Collection. About Search. Enable Autosuggest. Home Books Pharmacology for the Physical Therapist. Previous Chapter. Next Chapter. AMA Citation Chapter Antihyperlipidemic Drugs. Panus P. Peter C. Panus, et al.

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Antihyperlipidemic agents

The armamentarium for the treatment of dyslipidemia today comprises six different modes of action with overall around 24 different drugs. The treatment of lipid disorders was revolutionized with the introduction of statins which have become the most important therapeutic option available today to reduce and prevent atherosclerosis and its detrimental consequences like cardiovascular diseases and stroke. Consequently, the search for novel lipid-modifying drugs is still one of the most active areas in research and development in the pharmaceutical industry. Major focus lies on approaches to LDL-lowering drugs superior to statins with regard to efficacy, safety, and patient compliance and on approaches modifying plasma levels and functionality of HDL particles based on the clinically validated inverse relationship between high-plasma HDL levels and the risk for CVD. The available drugs today for the treatment of dyslipidemia are small organic molecules or nonabsorbable polymers for binding of bile acids to be applied orally. Besides small molecules for novel targets, biological drugs such as monoclonal antibodies, antisense or gene-silencing oligonucleotides, peptidomimetics, reconstituted synthetic HDL particles and therapeutic proteins are novel approaches in clinical development are which have to be applied by injection or infusion.

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Antilipidemic Drug Therapy Today and in the Future

Antihyperlipidemic agents promote reduction of lipid levels in the blood. Some antihyperlipidemic agents aim to lower the levels of low-density lipoprotein LDL cholesterol, some reduce triglyceride levels, and some help raise the high-density lipoprotein HDL cholesterol. By reducing the LDL cholesterol, they can prevent both the primary and secondary symptoms of coronary heart disease. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.

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Lipid-lowering agent

Hypolipidemic agents , cholesterol-lowering drugs or antihyperlipidemic agents , are a diverse group of pharmaceuticals that are used in the treatment of high levels of fats lipids , such as cholesterol, in the blood hyperlipidemia. They are called lipid-lowering drugs. These are drugs which lower the level of lipids and lipoproteins in blood. The several classes of hypolipidemic drugs may differ in both their impact on the cholesterol profile and adverse effects.

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