This document summarizes different agents used to treat hyperlipidemia when diet and exercise are not enough to achieve normal lipid levels. It outlines bile acid sequestrants which bind to bile acids to block absorption and can cause vitamin deficiencies and gastrointestinal issues. Niacin increases HDL but can cause flushing. Fibric acid derivatives have an unknown mechanism of action but inhibit triglyceride production and can cause liver and gastrointestinal side effects. Statins work by inhibiting the HMG-CoA reductase enzyme needed to produce cholesterol and are used for high cholesterol and other risk factors but can have muscle, liver and neurological side effects.

1. HYPERLIPIDEMIA AGENTS
for use when diet and exercise fail to give normal
levels:
LDL--100-129 mg/dL
HDL--60 mg/dL and above
triglycerides--Below 150 mg/dL
bile acid sequestrants-----these attach to bile acid
to block absorption. (bile from gall bladder breaks
down fat for absorption)
side effects---vit KADE deficiency,
constipation,naseau
examples---
cholestyramine/questran
colesevelem/welchol
colestipol/colestid
(hint---cholecystectomy is gallbladder removal)

2. • nicotinic acidB3(niacin)----increases HDL.
• niacin ‘flush’---vasodilator
• example---niaspan(rx)
fibric acid derivatives--
moa---exact unknown, inhibit triglyeride
production
side effects--liver enzyme levels, nausea,
respiratory issues
examples---
clofibrate/atromid-S
fenofibrate/tricor
gemfibrozil/lopid
hyperlipidemia

3. hyperlipidemia
HMG-CoA reductase inhibitors(statins)
hydroxy-methyl-glutaryl
HMG-CoA reductase makes enzyme needed to make
cholesterol.
indications---for high cholesterol and other risk factor
side effects---joint muscle pain,naseau, diarrhea,
constipation, liver damage, neurology issues
examples---
atorstatin/lipitor
lovastatin/mevacor
pravastatin/pravachol
simavastin/zocor