2. Drugs which lower the level of lipids
and lipoproteins in blood.
Lipids are transported in plasma as
lipoproteins.
Lipoproteins are classified into six
classes based on their particle size and
density
3. LIPOPROTEIN FUNCTION
1. Chylomicrons Dietary TG transport
2. Chylomicrons.rem Dietary cholesterol
transport
3. VLDL Endogenous TG
transport
4. IDL Transport
cholesterylesters and
TG to liver
5. LDL Transport cholesterol
to tissues and liver
6. HDL Removal of cholesterol
from tissues
FUNCTIONS OF LIPOPROTEIN
8. HMG CoA
HMG CoA reductase
Mevalonic acid
Decreases CH synthesis by inhibition of rate limiting HMG
CoA reductase
LDL 20-55%
HDL 5-15%
TG 10-35%
9.
First clinically used statin
Absorption is incomplete
1st pass metabolism extensive
Excreted in bile
T1/2 is short {1-4}hrs
10. Head ache ,nausea,bowel
upsets,rashes
Sleep disturbances
Increased serum
transaminase
Muscle tenderness & rise in
CPK levels occur
infrequently
Myopathy is more common.
Adverse effects
11. 1st choice of drugs for Primary hyper lipidaemia
with raised LDL & total CH levels.
Secondary hypercholesterolaemia.
Used in patients with MI,angina,stroke to lower
cholesterol levels.
13. • These are basic ion exchange resins supplied in
chloride form
• They are neither digested nor absorbed in gut
• They bind to bile acids in the intestine
• They increase faecal excretion of bile salts and CH
• resins can retard atherosclerosis
• Not popular clinically because they are
unpalatable,have to be taken in large doses,causes
flatulence and interfere with absorption of many
other drugs
• Have poor patient acceptability
18. To lower ldl-ch are statins.
Statin therapy should be commenced at low dose.
In adequate response,dose should be doubled at
6 wks interval.
Treatment based on LDL-CH level
19. Treatment of low HDL-CH level
The primary approaches of therapy is to reduce LDL–CH
level
Nicotinic acid has highest efficacy to rise HDL-CH level
followed by fibrates
20. Primary tg lowering drugs are fibrates and
nicotinic acid
Treatment depend on cause and severity
Treatment of raised TG level