Powerpoints Hypolipidemics

Plasma Lipids cholesterol and triglycerides Essential fatty acid linoleic acid and linolenic acid Poly-unsaturated Fatty Acid

Lipids with special functions ,[object Object],[object Object],2.Lipoproteins trigycerides+phospholipids+ cholesterol with apoproteins

[object Object],[object Object],[object Object],[object Object],[object Object]

Triglyceride(mostly) +phospholipids +protein Apoproteins-B-48, C, E, A-I, A-II B. VLDL -principal carrier of triglycerides Catabolism of VLDL results in the formation of LDL. (Beta-shift) Apoproteins-C species, B-100, E A . Chylomicrons Synthesis and Catabolism

D. LDL-cholesteryl esters (mostly) Apoproteins-B-100 E. HDL Apoprotein +phospholipids + cholesterol Apoproteins-A-I, A-II, C, E C. IDL - triglycerides + cholesteryl esters Apoproteins-B-100, E, C

[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Characteristic cellular components in atherosclerotic plaques. They are transformed macrophages and smooth muscle cells that are filled with CHOLESTERYL ESTERS . They are the result of endocytosis of chemically modified lipoproteins via as many as 4 molecular species of scavenger receptors (inability of these receptors to be down regulated by high intracellular levels of cholesterol). Interaction of collagen, fibrin, calcium Occlude coronary vessels or rupture of unstable plaques> occlusive thrombus Foam Cells

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Normal Values

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],Lifestyle MODIFICATION

[object Object],[object Object],[object Object],B. Familial hyperglyceridemia Severe-- ↑ VLDL, chylomicrons Moderate- ↑ VLDL , may ↑ chylomicrons C. Familial combined hyperlipoproteinemia ↑ VLDL, ↑LDL, ↑VLDL and LDL

D. Familial dysbetalipoproteinemia ↑ VLDL and chylomicron remnants E. Familial hypercholesterolemia Heterozygous or homozygous ↑ LDL F. Lp(a) hyperlipoproteinemia ↑ Lp(a)

[object Object],[object Object],[object Object]

Frederickson/WHO classification of Hyperlipoproteinemia None NS ++ + Chylomicrons + VLDL V Fibrates moderate ++ + VLDL IV Fibrates moderate ++ ++ VLDL III Fibrates, Statins resins HIGH ++ ++ LDL +VLDL IIb Statins +/ resins HIGH NS ++ LDL IIa NONE NS +++ + Chylomicrons I DRUG TREATMENT Atherosclerosis Risk TG Cholesterol Lipoprotein Elevated Type

Management of dyslipidemia ,[object Object],[object Object],[object Object]

[object Object],[object Object],B. FIBRIC ACID DERIVATIVES Clofibrate, Fenofibrate, Bezafibrate, Gemfibrozil C. BILE ACID BINDING RESINS Cholestyramine, Colestipol

[object Object],[object Object],[object Object],[object Object],E. PROBUCOL F. INHIBITORS OF INTESTINAL STEROL ABSORPTION Ezetimibe

NIACIN (Nicotinic Acid) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NIACIN ,[object Object],[object Object],[object Object],[object Object]

NIACIN TOXICITY ,[object Object],[object Object],[object Object],[object Object]

NIACIN TOXICITY ,[object Object],[object Object],[object Object],[object Object],[object Object]

FIBRIC ACID DERIVATIVES (D FIBRATES) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MECHANISM OF ACTION ,[object Object],[object Object],[object Object],[object Object],[object Object]

ADVERSE EFFECTS ,[object Object],[object Object],[object Object],[object Object],[object Object]

GEMFIBROZIL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object]

OTHER CONGENERS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

BILE ACID BINDING RESIN Colestipol & Cholestyramine ,[object Object],[object Object],[object Object],[object Object],[object Object]

BILE ACID RESINS TOXICITY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

COMPETITIVE INHIBITOR OF HMG – CoA REDUCTASE ( D STATINS ) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MECHANISM OF ACTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

STATINS TOXICITY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PROBUCOL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

INHIBITORS OF INTESTINAL STEROL ABSORPTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EZETIMIBE ,[object Object],[object Object],[object Object],[object Object],[object Object]

TREATMENT WITH DRUG COMBINATION ,[object Object],[object Object],[object Object],[object Object],[object Object]

DRUG COMBINATION ,[object Object],[object Object],[object Object],[object Object],[object Object]

Powerpoints Hypolipidemics

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Powerpoints Hypolipidemics