Antihyperlipidemic Drugs. c h a p t e r atherosclerosis bile acid sequestrants catalyst cholesterol high-density lipoproteins (HDL). HMG-CoA. Hypolipidemic agents, or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of high levels of fats (lipids), such as cholesterol, in the blood (hyperlipidemia). They are called lipid-lowering drugs . Contents. 1 Classes. Established. 2 Research; 3 References; 4 See also. Antihyperlipidemic Drugs. Hyperlipidemias. Hyperlipoproteinemias. Hyperlipemia. Hypercholestrolemia. Direct relationship with acute pancreatitis.
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If your institution subscribes to this resource, and you don’t have a MyAccess Profile, please contact your library’s reference desk for information on how to gain access to this resource from off-campus. Atherosclerosis is the abnormal accumulation of lipids and products resulting from an inflammatory antihyperlipidekic in the walls of arteries, and is the leading cause of death in the Western world.
Heart attacks, angina pectoris, peripheral arterial disease, and strokes are common sequelae of atherosclerosis. In some cases, lowering serum lipid concentrations has been shown to prevent the sequelae of atherosclerosis and decrease mortality in patients with a history of cardiovascular disease antihyperllipidemic hyperlipidemia.
The five drug classes discussed in this chapter Figure 26—1 are used to decrease serum concentrations of lipids in the blood hyperlipidemia and to prevent or reverse associated atherosclerosis, or, in the case of hypertriglyceridemia, prevent pancreatitis. Although the drugs are generally safe and effective, adverse effects include drug—drug interactions and rare toxic reactions in skeletal muscle and the liver. The five classes of lipid-lowering drugs.
These classes are based classiffication the mechanisms of action of these drugs. Lipids, mainly cholesterol and triglycerides, are transported in human plasma by macromolecular complexes termed lipoproteins.
Lipoproteins are composed of a lipid core surrounded by apolipoproteins that regulate the uptake and off-loading of lipids and interactions with cell membrane receptors. The lipoproteins that are primarily responsible for delivering cholesterol and triglycerides to peripheral tissues originate in the liver and contain a key apoprotein called B The uptake by cells of B—containing lipoproteins can occur by receptor-mediated endocytosis or by scavenger receptors.
Receptor-mediated uptake is a carefully regulated process that protects cells from being overloaded with lipids. In contrast, uptake by scavenger receptors is an unregulated process that can overwhelm the ability of a cell to sequester potentially toxic lipids safely.
Antihyperpipidemic in arterial walls use scavenger receptors to take up circulating lipoproteins, especially particles with apolipoproteins that have been modified by free radicals.
When these macrophages become overloaded with lipids, they are transformed into distressed foam cells that initiate a local inflammatory response. Engorged foam cells, foam cells that have burst, and the products of the inflammatory responses form the core of an atherosclerotic plaque.
Whereas plaques can slowly occlude coronary and cerebral vessels, clinical symptoms are more frequently precipitated by rupture of unstable plaques, leading to occlusive thrombi. Schematic diagram of lipoprotein handling by hepatocytes. The sites of action of several antihyperlipidemic drugs are shown.
For identification of abbreviations of the lipoproteins, some drug classes, and additional discussion, see text. Another lipoprotein, high-density lipoprotein HDLexerts several antiatherogenic effects. HDL participates in pathways that retrieve cholesterol from the artery wall and inhibit the oxidation of atherogenic lipoproteins.
ANTIHYPERLIPIDEMIC DRUGS – ppt download
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