Lecture Notes: Cholesterol Medications (Antilipemic Medications)

Overview

Focus on medications used to manage cholesterol levels.
Includes different classes: Statins, Cholesterol Absorption Inhibitors, Bile Acid Sequestrants, Fibric Acid Derivatives, and Niacin.

Purpose: Used for hypercholesterolemia and prevention of coronary heart disease in high-risk patients.
Mechanism: Decrease LDL ("lousy" cholesterol), increase HDL ("happy" cholesterol).
Side Effects:
- Hepatotoxicity
- Muscle pain
- Rhabdomyolysis
- GI upset
Administration Notes:
- Take with evening meal (cholesterol synthesis at night).
- Think "statin" before "satin sheets."
- Monitor liver function and creatine kinase levels.
- Avoid alcohol and grapefruit juice.

Examples: Colesevelam, Colestyramine
Mechanism: Bind to bile acids in intestine, increasing cholesterol excretion, lowering LDL levels.
Side Effects:
- Constipation
- GI upset
Administration Notes:
- Increase fiber and fluid intake to prevent constipation.
- Take with food and full glass of water.
- May interfere with absorption of fat-soluble vitamins (A, D, E, K).
- "Fat deck" mnemonic for vitamins.

Examples: Gemfibrozole, Fenofibrate
Mechanism: Decrease triglyceride production and transport; increase HDL levels.
Side Effects:
- GI upset
- Gallstones
- Hepatotoxicity
- Muscle pain
Administration Notes:
- Take 30 minutes before breakfast and dinner.
- Monitor liver function.

Purpose: Used in large doses for hypercholesterolemia.
Mechanism: Decreases lipoprotein and triglyceride synthesis.
Side Effects:
- Flushing of the face ("not nice")
- GI upset
- Pruritus
- Hepatotoxicity
- Possible hyperglycemia
Monitoring: Liver function and caution in diabetic patients due to hyperglycemia risk.

Next video will cover vitamins, minerals, and electrolytes for correcting imbalances.
This is part of a series on cardiovascular medications.