This document discusses dyslipidemia, including its classification and treatment options. Treatment involves both non-pharmacological methods like lifestyle changes and diet modifications, as well as pharmacological options like statins and fibrates. Statins are the most commonly used lipid-lowering drugs and work by inhibiting HMG-CoA reductase. They have beneficial pleiotropic effects but can cause adverse effects like myopathy and liver enzyme elevation. Fibrates are also used to treat dyslipidemia but can cause gastrointestinal side effects and interfere with nutrient absorption if not taken correctly. The document notes that combination drug therapy may be needed in some cases to adequately treat dyslipidemia.

1. Dr Shahinur Rahman Sarder
D-Card Student.
M Abdur Rahim Medical College, Dinajpur.

4. Dyslipidemia

7. Classification of dyslipidemia

11. Dyslipidemia treatment
A. Non-pharmacological
a. Lifestyle and risk factor modification
> weight reduction
> Regular exercise
> Smoking cessation
> Treatment of other risk factor HTN or DM
b. Diet
> Saturated fat intake<7%
> Total fat intake <30%
> dietary cholesterol < 200mg/day
> Olive oil in cooking are relatively beneficial
> more bread, fiber (10to25 g/day), more fish and less meat
with “no day without fruit”
B. Pharmacological
> Lipid lowering drugs

12. Lipid lowering drugs

13. Statins

15. Pleiotropic effects of statins

16. Pharmacokinetics Of Statins
• Well absorbed when given orally
• Extracted by the liver(Target Tissue), undergo extensive presynthetic
biotransformation
• Simvastatin is an inactivate prodrug
• Water soluble statins : Rosuvastatin, pravastatin
• Lipid soluble statins : Atrovastatin, Fluvastatin,Simvastatin
• Plasma t1/2 range from 1-3 hours(Atrovastatin 14hrs,Rosuvastatin 19
hrs)

25. Fibrates

28. Adverse effects
• Myopathy
• Liver enzymes elevation
• CPK elevation
• Myosities( Rhabdomyolysis),Myoglobulinuria (may cause renal failure)
• Cholelithiasis
• Pulmonary embolism
• Mild GIT symptoms
• Rarely skin rashes

29. Contraindications
• Hypersensitivity to fibrates
• Severe liver, renal disease
• Primary biliary cirrhosis
• Pre existing gallbladder disease
• Lactation

34. Adverse effects
.GIT symptoms
> Flatulence/abdominal bloating
> constipation
> Nausea
> Dyspepsia
.Increased TG level in predisposed patient
.Interfere with the absorption of fat soluble vitamins and drugs (digoxin,warfarin,chlorothiazide,thyroxine)
(For this reason this drug should given 1 hour before or 4-6 hour after resins)
.Impaired absorption of vitamin –K may lead to bleeding
.Long time use may cause increase HMG-CoA reductase activity that tends to increase cholesterol

46. Combination Therapy

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