Learning objectives
Upon completion of this chapter, you should be able to:
1.
Outline the mechanisms of fat metabolism in the body and discuss the role of hyperlipidaemia as a risk factor
for coronary artery disease.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most
common adverse reactions and important drug–drug interactions associated with the bile acid sequestrants,
HMG-CoA inhibitors, cholesterol absorption inhibitors and other agents used to lower lipid levels.
3.
Discuss the use of drugs that lower lipid levels across the lifespan.
4.
Compare and contrast the prototype drugs cholestyramine, atorvastatin and ezetimibe with various other
agents used to lower lipid levels.
5.
Outline the care considerations, including important teaching points, for people receiving drugs used to
lower lipid levels.
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Lipid-lowering agents
Glossary of key terms
antihyperlipidaemic agents:
general term used for drugs used to lower lipid levels in the blood
bile acids:
cholesterol-containing acids found in the bile that act like detergents to break up fats in the small intestine
cholesterol:
necessary component of human cells that is produced and processed in the liver, then stored in the bile until stimulus
causes the gallbladder to contract and send the bile into the duodenum via the common bile duct; a fat that is essential for the
formation of steroid hormones and cell membranes; it is produced in cells and taken in by dietary sources
chylomicron:
carrier for lipids in the bloodstream, consisting of proteins, lipids, cholesterol, and so forth
endocannabinoids:
endogenous substances that activate nervous system receptors that are important in the regulation of appetite,
food intake and metabolism
high-density lipoprotein (HDL):
loosely packed chylomicron containing fats, able to absorb fats and fat remnants in the periphery;
thought to have a protective effect, decreasing the development of coronary artery disease
hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase:
enzyme that regulates the last step in cellular cholesterol synthesis
hyperlipidaemia:
increased levels of lipids in the serum, associated with increased risk of coronary artery disease development
low-density lipoprotein (LDL):
tightly packed fats that are thought to contribute to the development of coronary artery disease when
remnants left over from the LDL are processed in the arterial lining
metabolic syndrome:
a collection of factors, including insulin resistance, abdominal obesity, low high-density lipoprotein and high
triglyceride levels, hypertension and proinflammatory and prothrombotic states that increase the incidence of coronary artery disease
risk factors:
factors that have been identified as increasing the risk of the development of a disease; for coronary artery disease, risk
factors include genetic predisposition, gender, age, high-fat diet, sedentary lifestyle, gout, hypertension, diabetes and oestrogen
deficiency
Test your current knowledge of lipid-lowering agents with a PrepU Practice Quiz!
LIPID-LOWERING AGENTS
Bile acid sequestrants
cholestyramine
colestipol
HMG-CoA reductase inhibitors
atorvastatin
fluvastatin
pravastatin
rosuvastatin
simvastatin
Cholesterol absorption inhibitor
ezetimibe
OTHER LIPID-LOWERING
AGENTS
Fibrates
fenofibrate
gemfibrozil
Vitamin B
nicotinic acid
