CLINICAL IMPORTANCE OF LIPOPROTEINS

Size: px
Start display at page:

Download "CLINICAL IMPORTANCE OF LIPOPROTEINS"

Transcription

1 25 Hyperlipidemias CLINICAL IMPORTANCE OF LIPOPROTEINS Raised levels of low-density lipoprotein (LDL) cholesterol and low levels of high density lipoprotein (HDL) cholesterol are independent risk factor for ischemic heart disease Raised levels of triglycerides, and lipoprotein a-lp (a) are linked to the extent and progression of atherosclerosis Lipid lowering plays great role in primary and secondary prevention of coronary events. Important Lipids in the Blood 1. Cholesterol 2. Triglycerides (TGL) 3. Fatty acids (non esterified) 4. Phospholipids. PHYSIOLOGICAL FUNCTIONS OF LIPIDS 1. Lipids synthesize cell membranes. 2. Provide energy. 3. Help in the absorption of fat-soluble vitamins. Transportation in blood: Lipids are transported in blood as lipoproteins since lipids by themselves are insoluble in blood. Hence they are combined with apoproteins and transported. These compounds are called Lipoproteins of which 5 important types are present. CLASSIFICATION OF LIPOPROTEINS BASED ON ULTRACENTRIFUGATION/ELECTROPHORESIS (FIG. 25.1) Classified according to their density: Chylomicrons: Transport dietary TGL from intestine into circulation VLDL- synthesised in liver and intestine: Function is to transport TGL. Intermediate density lipoproteins-idl Low-density lipoproteins LDL: Transport 75% of total plasma cholesterol.

2 184 Comprehensive Cardiology High-density lipoproteins HDL; synthesized in liver and intestine and are important for mobilization of tissue cholesterol. (TGL-Triglyceride) Note: After overnight fasting chylomicrons disappear from the blood and the lipoproteins measured are VLDL, LDL and HDL. Importance of identification Types: LDL, which transports mainly cholesterol, correlates strongly with the development of myocardial infarction HDL shows a negative correlation and increased levels are desirable The risk of CHD from TGL rise is related to associated abnormalities in glucose tolerance, body weight and HDL cholesterol. Constituents of lipoproteins (Fig. 25.2) Central core of triglycerides and cholesterol esters, surrounded by a coat of phospholipids, cholesterol and proteins called apoproteins or apolipoprotein. APOPROTEINS Fig. 25.1: Electrophoretic separation of lipoproteins Apoproteins constitute a varied collection of proteins with varying structures, e.g. apolipoprotein A, B, C, D and E with various subtypes. They stabilize the lipoprotein particles Have receptor recognizing function Influence enzyme functions activate or inhibit enzymes.

3 Hyperlipidemias 185 Fig. 25.2: Structure of lipoprotein Apoprotein A is associated with HDL Apoprotein B is associated with LDL and VLDL Apoprotein C is contained in chylomicron Lipoprotein (a) {Lp(a)} resembles LDL cholesterol in composition; this can also accelerate atherosclerosis. Apoprotein B in LDL is another atherogenic factor Lp (a): Lipoprotein little a Lp (a) is a particle of LDL cholesterol. Links to a glycoprotein by a disulphide bond. Importance of Lp (a) 1. It promotes atherogenesis 2. It is structurally similar to plasminogen and so it promotes thrombogenesis 3. It is a major and independent risk factor for atherogenesis. Optimum level should be under 20 mg/dl Currently there is no medicine or drug to effectively lower Lp (a) Drugs being tried to lower Lp (a)- are high doses of niacin and vitamin C Lipid transport in the blood Lipids are macromolecules insoluble in blood Un bound fatty acids have severe toxic effects on the body Some are bound to albumin and are carried in blood but the entire bulk cannot be. More fatty acids can be transported in esterified form- triacyl glycerol These hydrophobic neutral lipids are carried inside the core of specific lipoproteins

4 186 Comprehensive Cardiology Lipids inside the core are: Most hydrophobic ones TGL, and esterified cholesterol. They are protected from aqueous environment by an outer coat of more hydrophilic lipids, i.e. free cholesterol and glycerol phospholipids. Summary of fatty acid metabolism: Lipid transport system transports hydrophobic lipid molecules from site of synthesis to site of utilization. TGL is transported through digestive system and liver to peripheral sites of utilization (muscle) and storage (adipose tissue) Cholesterol is transported to liver forbile acid synthesis and for excretion from the body. Details of fatty acid metabolism: Two sources of lipids (Flow chart 25.1, Figs 25.3 and 25.4) Lipids originate from two sources: 1. Endogenous lipids synthesized in the liver. 2. Exogenous lipids: Ingested and processed in the intestine. a. Dietary cholesterol and TGL are converted in the intestine to chylomicrons, which enter blood stream via lymphatics. On reaching muscles and fatty tissues, LPL in capillaries breaks them to fatty acids, which then enters the muscle cells to provide energy. b. The remnants of chylomicrons which have lost most of TGL are taken up by the liver cells for disposal. c. Liver: Synthesises cholesterol and TGL, converts them to VLDL and releases them into blood. Theses reach muscles and adipose tissues. VLDL consists mainly of TGL which is hydrolysed by LPL (Lipoprotein Lipase) in capillaries, to fatty acids. They are then released and taken up by surrounding muscles to get energy. Some are taken up by adipose tissue. d. During this, VLDL is made progressively more dense and is converted to LDL. Most of the LDL is taken by liver; some circulate and provide cholesterol to rest of the body tissues. e. HDL is also secreted in liver. It remove surplus cholesterol from tissues, tranfer to LDL, which returns to liver. f. Liver in addition synthesises cholesterol to make bile acids. g. To regulate cholesterol uptake liver varies LDL receptors. HMG CoAR is the rate-limiting enzyme of cholesterol synthesis in liver. DYSLIPIDEMIA / HYPERLIPIDEMIA Hyperlipidemias are abnormalities of lipoprotein levels which promote development of atherosclerosis and coronary heart diseases.

5 Flow chart 25.1: Normal pathway of lipid transport Hyperlipidemias 187 Types Primary hyperlipidemia. Secondary hyperlipidemia. Primary Caused by genetic abnormalities affecting apoproteins, their receptors and enzymes involved in lipoprotein metabolism. (Frederickson classfication) Secondary Caused by certain clinical conditions. Diabetes, myxedema, renal disease, alcohol abuse, biliary obstruction, acute pancreatitis. Diets Rich in saturated fats also cause hypercholesterolemia by reducing hepatic lipoprotein clearance.

6 188 Comprehensive Cardiology Fig. 25.3: Exogenous lipoprotein pathways Fig. 25.4: Endogenous lipoprotein pathway Drugs Steroids, oral contraceptive (estrogen containing), thiazides, non-selective beta-blockers, isotretinoin (in acne).

7 Hyperlipidemias 189 Frederickson/WHO classification identifies 6 phenotypes: Type IIa; It is essentially hypercholesterolemia (LDL chol); normal TGL. Type I, IV and V: These are essentially hypertriglyceridemia ( VLDL and chylomicrons) Type IIb and III: Hypercholesterolemia with hypertriglyceridemia. LDL Cholesterol Level Less than100 mg/dl Optimal mg/dl Near optimal/above optimal mg/dl Borderline high mg/dl High 190 mg/dl and above Very high HDL Cholesterol Level Less than 40 mg/dl Low (increased risk) 60 mg/dl and above High (heart protective) Normal Range of lipid level: Total cholesterol mg/dl Triglycerides mg/dl LDL cholesterol ( mg) HDL cholesterol (40-60 mg) Lipids Desirable Levels of Blood Lipids Desirable levels Mg/dl of plasma Mmol/L Total cholesterol < 200 < 5 LDL-C < 130 < 3 HDL-C For women > 55 >1 For men > 45 >1 Triglycerides < 130 < 2 Ratio total:hdl-c < 4.5

8 190 Comprehensive Cardiology Recommendation of National Cholesterol Education Program (NCEP) in US: Indications of lipid lowering therapy Clinical state With CHD Free of CHD but two or more risk factors Free of CHD but with one risk factor Level of LDL at which to consider therapy More than 100 mg/dl (2.5 mmol/l) More than 130 mg/dl More than 160 mg/dl TREATMENT OF HYPERLIPIDEMIA Aim; To lower LDL cholesterol and triglycerides and to raise HDL cholesterol. Aggressive treatment required in CHD and when multiple CVS risks are present. Therapy can cause regression of existing atherosclerosis. Desirable levels of total cholesterol < 200 mg/dl (5.2 mmol/l) Stages in therapy for hyperlipidemia Stage I A. Diet therapy Reduce calories in obese to achieve ideal body weight Total fat should be 30% of energy intake Low fat and high carbohydrate diet; avoid refined sugar Avoid saturated fat (dairy products to be avoided) Use high fiber diet Avoid egg yoke, butter, cream, lard, fatty meat, and red meat Use margarine, vegetable oils, chicken and turkey; Recommend intake of oily fish, (mackerel, trout, salomon-) These contain proteins and omega 3 polyunsaturated fats Recommend vegetables, fibers, fruits about 5 portions a day This diet will reduce both cholesterol and TGL If diet fails to reduce/normalize lipids after 6 mths Drugs indicated. B. Exercise: Raises HDL levels. Constitutes important part of therapy. Stage II. Drug therapy Summary Statins for elevated LDL Fibrates for low HDL levels Bile acid sequestrants for women of child-bearing age since statins and fibrates are contraindicated in them. Nicotinic acid and derivatives for hypertriglyceridemia and low HDL.

9 Hyperlipidemias 191 A. Statins: Drugs Daily dose range Simvastatin mg Lovastatin mg(bd) Pravastatin mg Atorvastatin mg Fluvastatin mg Cerivastatin µg (withdrawn) Rosuvastatin 40 mg These drugs vary in potency and cost (Fluvastatin is weakest, cheaper, Atorvastatin most potent and costly) (All have similar mode of action and side effect). Mode of action of statins: They inhibit HMG CoA reductase which is the rate-limiting enzymein the production of cholesterol by the liver. These agents reduce total cholesterol and LDL (TGL-slightly), Increase, hepatic LDL receptors and HDL Increase in HDL occurs, especially with atorvastatin Maximum effect in 1 month. Side effects: Idiosyncratic and dose related. Elevated LFT results, elevated muscle CPK due to myopathy, rarely rhabdomyolysis this risk increased by cyclosporine. Avoid statins in; liver disease, alcoholism, pregnancy, lactation Stop statins if liver enzyme levels exceeds 3 times normal or - if patient develops muscle pain. Place in therapy; first line drug when LDL cholesterol is high. B. Bile acid binding anion exchange resins Drugs: Cholestyramine 4-8 gm tds Colestipol 5-10 gm tds Colesevelam 625 mg tablets 6 tablets per day. Mode of action: These bind bile acids in the small bowel and -Form an insoluble complex. -Prevent their reabsorption in the distal 200 cm of ileum increasing their excretion This in turn induces more free bile acids to be produced (in the liver) and secreted in the bile. Consequently more hepatic cholesterol is utilized; resulting in depletion of hepatic cholesterol, this leading to increase in LDL receptors on the liver cell, and this in turn increases clearance of LDL from the plasma.

10 192 Comprehensive Cardiology Hence higher level of cholesterol is absorbed from plasma to synthesis more bile salts. Side effects: Cause little systemic effects since they are not absorbed from intestine Nausea, vomiting, constipation, bloating, flatulence, hemorrhoids, intestinal obstruction these GI effects, since they are to be taken in high doses (upto 30 gm/day) Fat-soluble vitamin supplementation may be needed. Drug absorption reduced, e.g. of digoxin, thyroxin, warfarin. Can raise serum triglycerides level. Colesevelam-causes less GI tract side effects. Place in therapy: Indicated in premenopausal women-as fibrates and statins are contraindicated in pregnancy and at time of conception. Fibrates Fibric acid derivatives Primarily drugs for hypertriglyceridemia and when LDL cholesterol is low Drugs: Gemfibrozil, gemfibrozil, clofibrate, ciprofibrate, feno fibrate, beza fibrate. Action; exact mechanism not known. Suggestions mechanisms Stimulate lipoprotein lipase this enzyme catalyses VLDL, i.e. they increase VLDL catabolism and decrease VLDL production They also induce changes in LDL composition, which makes it less atherogenic and enhance fibrolysis. Place in therapy for fibretes: Primary drug for hypertriglyceridemia; mainly used in type IIb and III hyperlipidemia. Side effects: GI disturbances, risk for muscle toxicity leading to myoglobinuria causing renal failure especially if combined with statins or with excessive alcohol use. Avoid in liver and renal disease, children, pregnant women. Risk for gallstones, as increased amount of cholesterol is excreted in bile. Dose: Bezafibrate 200 mg tds after food; Clofibrate (Atromid) (not used nowadays) 500 mg tds; Gemfibrozil (Lopid) 600 mg bd. C. Nicotinic acid Action: It reduces both cholesterol and TGL in plasma; but high doses are required. Acts by reducing synthesis of VLDL in liver; Decreases LDL synthesis by reducing apoprotein B in liver.

11 Hyperlipidemias 193 Side effects; GI disturbances, pruritis, flushing, hyperglycemia, hyperurecemia, rise in liver enzymes. Rarely hyperpigmentation, acanthosis nigricans: Flushing is reduced by adding small doses of aspirin Dose: Start with 100 mg tds; gradually increase to1gm tds. Maximum recommended dose is 2 gm per day. Avoid in: Liver disease, gout, and h/o recent peptic ulcer LFT to be monitored. Omega 3 polyunsaturated fatty acids; Occur in purified fish oils Contain long chain fatty acids. Inhibit thrombosis Competitively antogonise thromboxanea 2 Lower the plasma triglyceride levels. Dose: 3-6 gm/day. D. Other modalities of treatment Indications: Reserved for hyperlipedemia is refractory to diet and drug therapy. For example, in those with homozygous hypercholesterolemia, (usually children): with very high levels. I. LDL apheresis Extracorporeal removal of LDL similar to plasma exchange every 2 to 3 weeks and similar to renal dialysis very expensive. Plasma exchange with LDL immunoabsorber column. II. Surgery Resection of distal 200 cm of ileum or bypassing of this segment. Porta caval shunt-less hazardous than liver transplant; Reduces LDL-C levels by 50%; exact mechanism not known. Liver and heart transplant Liver transplant provides new LDL receptors. Heart transplant required if in very early childhood severe premature CHD develops. III. Gene Therapy Involves replacement of abnormal LDLr gene with a normal gene; - Hepatocytes are obtained from patient s left lobe, cultured and these are transfected with a recombinant retrovirus containing normal human LDLr gene; These cells are transferred back to patient via a porto venous catheter: risk involved in surgery is more than the benefit. Another method of gene therapy: To enable liver to express VLDL receptor by transfection of VLDL receptor gene. Regression of coronary lesions on treatment Regression of coronary atherosclerotic lesion has been shown to occur with vigorous therapy to lower serum LDL cholesterol, in various trials.

12 194 Comprehensive Cardiology RECENT ADVANCES More potent statins: are being developed. MTP inhibitors: MTP transfers TGL to apoprotein. It is essential for the synthesis of chylomicrons and VLDL. Dietary and biliary cholesterol absorption inhibitor Ezetimibeanother drug launched, and found effective and is extensively used. ACAT inhibitor: Have failed to reach the market yet.

Antihyperlipidemic Drugs

Antihyperlipidemic Drugs Antihyperlipidemic Drugs Lipid disorders: Disorders of lipid metabolism are manifest by elevation of the plasma concentrations of the various lipid and lipoprotein fractions (total and LDL cholesterol,

More information

ANTIHYPERLIPIDEMIA. Darmawan,dr.,M.Kes,Sp.PD

ANTIHYPERLIPIDEMIA. Darmawan,dr.,M.Kes,Sp.PD ANTIHYPERLIPIDEMIA Darmawan,dr.,M.Kes,Sp.PD Plasma lipids consist mostly of lipoproteins Spherical complexes of lipids and specific proteins (apolipoproteins). The clinically important lipoproteins, listed

More information

Antihyperlipidemic Drugs

Antihyperlipidemic Drugs Antihyperlipidemic Drugs Hyperlipidemias. Hyperlipoproteinemias. Hyperlipemia. Hypercholestrolemia. Direct relationship with acute pancreatitis and atherosclerosis Structure Lipoprotein Particles Types

More information

Antihyperlipidemic drugs

Antihyperlipidemic drugs Antihyperlipidemic drugs The clinically important lipoproteins are LDL low density lipoprotein, VLDL very low density lipoprotein, HDL high density lipoprotein. Hyperlipidemia may caused 1. by individual

More information

DYSLIPIDEMIA PHARMACOLOGY. University of Hawai i Hilo Pre- Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D

DYSLIPIDEMIA PHARMACOLOGY. University of Hawai i Hilo Pre- Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D DYSLIPIDEMIA PHARMACOLOGY University of Hawai i Hilo Pre- Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D 1 LEARNING OBJECTIVES Know normal cholesterol levels Understand what the role

More information

Introduction Hyperlipidemia hyperlipoproteinemia Primary hyperlipidemia (Familial) Secondary hyperlipidemia (Acquired)

Introduction Hyperlipidemia hyperlipoproteinemia Primary hyperlipidemia (Familial) Secondary hyperlipidemia (Acquired) Introduction Hyperlipidemia, or hyperlipoproteinemia, is the condition of abnormally elevated levels of any or all lipids and/or lipoproteins in the blood. Hyperlipidemias are divided in primary and secondary

More information

Anti Hyperlipidemic Drugs. Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia

Anti Hyperlipidemic Drugs. Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia Anti Hyperlipidemic Drugs Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia Lipoproteins Macromolecular complexes in the blood that transport lipids Apolipoproteins

More information

MOLINA HEALTHCARE OF CALIFORNIA

MOLINA HEALTHCARE OF CALIFORNIA MOLINA HEALTHCARE OF CALIFORNIA HIGH BLOOD CHOLESTEROL IN ADULTS GUIDELINE Molina Healthcare of California has adopted the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel

More information

PIEDMONT ACCESS TO HEALTH SERVICES, INC. Guidelines for Screening and Management of Dyslipidemia

PIEDMONT ACCESS TO HEALTH SERVICES, INC. Guidelines for Screening and Management of Dyslipidemia PIEDMONT ACCESS TO HEALTH SERVICES, INC. Policy Number: 01-09-021 SUBJECT: Guidelines for Screening and Management of Dyslipidemia EFFECTIVE DATE: 04/2008 REVIEWED/REVISED: 04/12/10, 03/17/2011, 4/10/2012,

More information

Hyperlipidemia. Prepared by : Muhannad Mohammed Supervisor professor : Dr. Ahmed Yahya Dallalbashi

Hyperlipidemia. Prepared by : Muhannad Mohammed Supervisor professor : Dr. Ahmed Yahya Dallalbashi Hyperlipidemia Prepared by : Muhannad Mohammed Supervisor professor : Dr. Ahmed Yahya Dallalbashi Outline The story of lipids Definition of hyperlipidemia Classification of hyperlipidemia Causes of hyperlipidemia

More information

Hypertriglyceridemia. Ara Metjian, M.D. Resident s Report 20 December 2002

Hypertriglyceridemia. Ara Metjian, M.D. Resident s Report 20 December 2002 Hypertriglyceridemia Ara Metjian, M.D. Resident s Report 20 December 2002 Review of Lipids Chylomicrons (CM): Dietary lipids absorbed through the GI tract are assembled intracellularly into CM. Very Low

More information

Management of Post-transplant hyperlipidemia

Management of Post-transplant hyperlipidemia Management of Post-transplant hyperlipidemia B. Gisella Carranza Leon, MD Assistant Professor of Medicine Lipid Clinic - Vanderbilt Heart and Vascular Institute Division of Diabetes, Endocrinology and

More information

Lipid Lowering Drugs. Dr. Alia Shatanawi

Lipid Lowering Drugs. Dr. Alia Shatanawi Lipid Lowering Drugs Dr. Alia Shatanawi Atherosclerosis A form of arteriosclerosis characterized by the deposition of atheromatous plaques containing cholesterol and lipids on the innermost layer of the

More information

Dyslipidemia. (Med-341)

Dyslipidemia. (Med-341) Dyslipidemia (Med-341) Anwar A Jammah, MD, FRCPC, FACP, CCD, ECNU. Associate Professor of Medicine Consultant Medicine, Endocrinology, Thyroid Oncology Department of Medicine, King Saud University The

More information

Imbalances in lipid components

Imbalances in lipid components Drugs for Dyslipidemia Vivien Gam, Pharm.D. 1 Dyslipidemia Imbalances in lipid components High total cholesterol High LDL cholesterol Low HDL cholesterol High triglycerides Significant risk factor for

More information

Plasma lipoproteins & atherosclerosis by. Prof.Dr. Maha M. Sallam

Plasma lipoproteins & atherosclerosis by. Prof.Dr. Maha M. Sallam Biochemistry Department Plasma lipoproteins & atherosclerosis by Prof.Dr. Maha M. Sallam 1 1. Recognize structures,types and role of lipoproteins in blood (Chylomicrons, VLDL, LDL and HDL). 2. Explain

More information

Copy right protected Page 1

Copy right protected Page 1 CHOLESTEROL and TGs LOWERING DRUGS Introduction: Fat (lipids) are combinations (esters) of fatty acids plus an alcohol. The two main fats in the body are triglycerides (TGs) and cholesterol Triglycerides

More information

Financial Disclosures

Financial Disclosures 1 Lipids in Type 2 Diabetes July 20, 2013 Abhimanyu Garg, M.D. Professor of Internal Medicine Chief, Division of Nutrition and Metabolic Diseases Distinguished Chair in Human Nutrition Research UT Southwestern

More information

Unit IV Problem 3 Biochemistry: Cholesterol Metabolism and Lipoproteins

Unit IV Problem 3 Biochemistry: Cholesterol Metabolism and Lipoproteins Unit IV Problem 3 Biochemistry: Cholesterol Metabolism and Lipoproteins - Cholesterol: It is a sterol which is found in all eukaryotic cells and contains an oxygen (as a hydroxyl group OH) on Carbon number

More information

Lipid Therapy: Statins and Beyond. Ivan Anderson, MD RIHVH Cardiology

Lipid Therapy: Statins and Beyond. Ivan Anderson, MD RIHVH Cardiology Lipid Therapy: Statins and Beyond Ivan Anderson, MD RIHVH Cardiology Outline The cholesterol hypothesis and lipid metabolism The Guidelines 4 Groups that Benefit from Lipid therapy Initiation and monitoring

More information

Drug regulation of serum lipids

Drug regulation of serum lipids Drug regulation of serum lipids Foundations of Biomedical Science MEDS90001 Dr Michelle Hansen Pharmacology & Therapeutics mjhansen@unimelb.edu.au References Katzung, Basic & Clinical Pharmacology Ch 35

More information

Drugs for Dyslipidemias

Drugs for Dyslipidemias Drugs for Dyslipidemias HMG CoA reductase inhibitors (statins): atorvastatin, lovastatin, pravastatin, simvastatin Bile acid-binding resins: cholestyramine, colestipol, colesevelam Fibric acid derivatives

More information

A Review: Atherosclerosis & its treatment

A Review: Atherosclerosis & its treatment 73 Review Article A Review: Atherosclerosis & its treatment Yogesh K. Patil* Department of Pharmacology, Shree Mahavir Institute of Pharmacy, Nashik, Maharashtra, India *yogesh_kpatil85@yahoo.co.in ABSTRACT

More information

Lipids digestion and absorption, Biochemistry II

Lipids digestion and absorption, Biochemistry II Lipids digestion and absorption, blood plasma lipids, lipoproteins Biochemistry II Lecture 1 2008 (J.S.) Triacylglycerols (as well as free fatty acids and both free and esterified cholesterol) are very

More information

ANSC/NUTR 618 LIPIDS & LIPID METABOLISM Lipoprotein Metabolism

ANSC/NUTR 618 LIPIDS & LIPID METABOLISM Lipoprotein Metabolism ANSC/NUTR 618 LIPIDS & LIPID METABOLISM Lipoprotein Metabolism I. Chylomicrons (exogenous pathway) A. 83% triacylglycerol, 2% protein, 8% cholesterol plus cholesterol esters, 7% phospholipid (esp. phosphatidylcholine)

More information

Dyslipidemia. Team Members: Laila Mathkour, Khalid Aleedan, Bayan Al-Mugheerha, Fatima AlTassan

Dyslipidemia. Team Members: Laila Mathkour, Khalid Aleedan, Bayan Al-Mugheerha, Fatima AlTassan Dyslipidemia Objectives: Not given. Team Members: Laila Mathkour, Khalid Aleedan, Bayan Al-Mugheerha, Fatima AlTassan Team Leader: Amal Alshaibi Revised By: Yara Aldigi and Basel almeflh Resources: 435

More information

Classification. Etiology

Classification. Etiology Dyslipidemia Dyslipidemia is the elevation of plasma cholesterol, triglycerides (TGs), or both, or a low high-density lipoprotein level that contributes to the development of atherosclerosis. Causes may

More information

13/09/2012. Dietary fatty acids. Triglyceride. Phospholipids:

13/09/2012. Dietary fatty acids. Triglyceride. Phospholipids: CARDIOVASCULAR DISEASES (CVD) and NUTRITION Major cause of morbidity & mortality in Canada & other developed countries e.g., majority of approved health claims on food labels relate to lowering CVD Relation

More information

Podcast (Video Recorded Lecture Series): Lipoprotein Metabolism and Lipid Therapy for the USMLE Step One Exam

Podcast (Video Recorded Lecture Series): Lipoprotein Metabolism and Lipid Therapy for the USMLE Step One Exam Podcast (Video Recorded Lecture Series): Lipoprotein Metabolism and Lipid Therapy for the USMLE Step One Exam Howard J. Sachs, MD www.12daysinmarch.com Email: Howard@12daysinmarch.com Podcast (Video Recorded

More information

Lipid Guidelines Who, What, and How Low. Anita Ralstin, MS, CNP Next Step Health Consultant, LLC New Mexico Heart Institute

Lipid Guidelines Who, What, and How Low. Anita Ralstin, MS, CNP Next Step Health Consultant, LLC New Mexico Heart Institute Lipid Guidelines Who, What, and How Low Anita Ralstin, MS, CNP Next Step Health Consultant, LLC New Mexico Heart Institute Disclosures! None Objectives! List factors used in screening for dyslipidemia

More information

PATIENT INFORMATION. Medicine To Treat: C ardiac Diseases. Lipid-Lowering Medicines. Statins Fibrates Fat Binding Agents Nicotinic Acid Group

PATIENT INFORMATION. Medicine To Treat: C ardiac Diseases. Lipid-Lowering Medicines. Statins Fibrates Fat Binding Agents Nicotinic Acid Group PATIENT INFORMATION Medicine To Treat: C ardiac Diseases Lipid-Lowering Medicines Statins Fibrates Fat Binding Agents Nicotinic Acid Group ABOUT YOUR MEDICINE Your doctor has just prescribed for you: Medicine

More information

Moh Tarek + Suhayb. Tamara Al-Azzeh + Asmaa Aljeelani ... Faisal

Moh Tarek + Suhayb. Tamara Al-Azzeh + Asmaa Aljeelani ... Faisal 28 Moh Tarek + Suhayb Tamara Al-Azzeh + Asmaa Aljeelani... Faisal Digestion of dietary lipids Lipid digestion and absorption are complex processes. They involve soluble enzymes, substrates with different

More information

Lipoproteins Metabolism Reference: Campbell Biochemistry and Lippincott s Biochemistry

Lipoproteins Metabolism Reference: Campbell Biochemistry and Lippincott s Biochemistry Lipoproteins Metabolism Reference: Campbell Biochemistry and Lippincott s Biochemistry Learning Objectives 1. Define lipoproteins and explain the rationale of their formation in blood. 2. List different

More information

Chapter VIII: Dr. Sameh Sarray Hlaoui

Chapter VIII: Dr. Sameh Sarray Hlaoui Chapter VIII: Dr. Sameh Sarray Hlaoui Lipoproteins a Lipids are insoluble in plasma. In order to be transported they are combined with specific proteins to form lipoproteins: Clusters of proteins and lipids.

More information

Fats and Other Lipids

Fats and Other Lipids Fats and Other Lipids Chapter 6 Chapter 6: Fats and other Lipids 1 6.1 Understanding Lipids Lipids include: 1. Fatty acids 2. Triglycerides 3. Phospholipids 4. Cholesterol Oil and Water Don t Mix Because

More information

Digestion and transport of TAG by plasma lipoproteins

Digestion and transport of TAG by plasma lipoproteins Digestion and transport of TAG by plasma lipoproteins Lipoproteins are multimolecular complexes of lipids and proteins, they are not macromolecules They transport lipids in the plasma because lipids are

More information

B. Patient has not reached the percentage reduction goal with statin therapy

B. Patient has not reached the percentage reduction goal with statin therapy Managing Cardiovascular Risk: The Importance of Lowering LDL Cholesterol and Reaching Treatment Goals for LDL Cholesterol The Role of the Pharmacist Learning Objectives 1. Review the role of lipid levels

More information

Cholesterol metabolism. Function Biosynthesis Transport in the organism Hypercholesterolemia

Cholesterol metabolism. Function Biosynthesis Transport in the organism Hypercholesterolemia Cholesterol metabolism Function Biosynthesis Transport in the organism Hypercholesterolemia - component of all cell membranes - precursor of bile acids steroid hormones vitamin D Cholesterol Sources: dietary

More information

Lipid Metabolism in Familial Hypercholesterolemia

Lipid Metabolism in Familial Hypercholesterolemia Lipid Metabolism in Familial Hypercholesterolemia Khalid Al-Rasadi, BSc, MD, FRCPC Head of Biochemistry Department, SQU Head of Lipid and LDL-Apheresis Unit, SQUH President of Oman society of Lipid & Atherosclerosis

More information

Comprehensive Treatment for Dyslipidemias. Eric L. Pacini, MD Oregon Cardiology 2012 Cardiovascular Symposium

Comprehensive Treatment for Dyslipidemias. Eric L. Pacini, MD Oregon Cardiology 2012 Cardiovascular Symposium Comprehensive Treatment for Dyslipidemias Eric L. Pacini, MD Oregon Cardiology 2012 Cardiovascular Symposium Primary Prevention 41 y/o healthy male No Medications Normal BP, Glucose and BMI Social History:

More information

MMBS, MMED (Path),MAACB, MACTM, MACRRM

MMBS, MMED (Path),MAACB, MACTM, MACRRM Dr Mere Kende MMBS, MMED (Path),MAACB, MACTM, MACRRM Lecturer- SMSH Brief Overview of Lipids What is dyslipidemia? Classification of hyperlipidemia Primary vs secondary hyperlipidemia Hypercholesterolaemia

More information

ATP III (Adult Treatment Panel III) CLASSIFICATION C IN ADULTS

ATP III (Adult Treatment Panel III) CLASSIFICATION C IN ADULTS LABORATORY AND RISK FACTORS OF ATHEROSCLEROSIS S R. Mohammadi Biochemist (Ph.D.) Faculty member of Medical Faculty RISK FACTORS FOR CHD Clinical Risk Factors Laboratory Risk Factors MAJOR CLINICAL RISK

More information

Pathophysiology of Lipid Disorders

Pathophysiology of Lipid Disorders Pathophysiology of Lipid Disorders Henry Ginsberg, M.D. Division of Preventive Medicine and Nutrition CHD in the United States CHD is the single largest killer of men and women 12 million have history

More information

CHM333 LECTURE 34: 11/30 12/2/09 FALL 2009 Professor Christine Hrycyna

CHM333 LECTURE 34: 11/30 12/2/09 FALL 2009 Professor Christine Hrycyna Lipid Metabolism β-oxidation FA Acetyl-CoA Triacylglycerols (TAGs) and glycogen are the two major forms of stored energy in vertebrates Glycogen can supply ATP for muscle contraction for less than an hour

More information

Index. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A ACC/AHA. See American College of Cardiology/ ACE inhibitors. See Angiotensin-converting enzyme (ACE) inhibitors American College of Cardiology/American

More information

Non-Statin Lipid-Lowering Agents M Holler - Last updated: 10/2016

Non-Statin Lipid-Lowering Agents M Holler - Last updated: 10/2016 Drug/Class Cholestyramine (Questran) Bile acid sequestrant Generic? Lipid Effects Y/N (monotherapy) Y LDL : 9% (4 g to 8 ; 21% (16 g to 20 ; 23% to 28% (>20 HDL : 4% to 8% (16 to 24 TG : 11% to 28% (4

More information

CHOLESTEROL REDUCING MEDICATIONS. Five Main Categories. 1. Statins 2. Fibrates 3. Resins 4. Niacin 5. Cholesterol absorption inhibitor

CHOLESTEROL REDUCING MEDICATIONS. Five Main Categories. 1. Statins 2. Fibrates 3. Resins 4. Niacin 5. Cholesterol absorption inhibitor Page 1 of 5 PHA-GEN-002-2004 CHOLESTEROL REDUCING MEDICATIONS Five Main Categories 1. Statins 2. Fibrates 3. Resins 4. Niacin 5. Cholesterol absorption inhibitor Statins Also called HMG-CoA reductase inhibitors

More information

Lipids Types, Food Sources, Functions

Lipids Types, Food Sources, Functions Lipids Types, Food Sources, Functions What Are Lipids? Lipids Diverse group of molecules that are insoluble in water Fats The lipid content of diets and foods 1 Lipids in Body Cells and Tissues Types of

More information

Glossary For TheFatNurse s For All Ages Series Apolipoprotein B (APOB or ApoB) are the primary apolipoproteins of chylomicrons and low-density lipoproteins (LDL - known commonly by the misnomer "bad cholesterol"

More information

Topic 11. Coronary Artery Disease

Topic 11. Coronary Artery Disease Topic 11 Coronary Artery Disease Lipid metabolism http://news.bbc.co.uk/2/hi/health/7372495.stm Sterol Metabolism and Coronary Artery Disease Big Picture: Exogenous Cholesterol and Fat Metabolism Fats-Triglycerides

More information

Lipoprotein Formation, Structure and Metabolism: Cholesterol Balance and the Regulation of Plasma Lipid Levels

Lipoprotein Formation, Structure and Metabolism: Cholesterol Balance and the Regulation of Plasma Lipid Levels Lipoprotein Formation, Structure and Metabolism: Balance and the Regulation of Plasma Lipid Levels David E. Cohen, MD, PhD Director of Hepatology, Gastroenterology Division, Brigham and Women s Hospital

More information

Pediatric Dyslipidemia: Angela Gooden MSN, RN, CPNP- AC/PC, Texas Children s Hospital, Pediatric Cardiology

Pediatric Dyslipidemia: Angela Gooden MSN, RN, CPNP- AC/PC, Texas Children s Hospital, Pediatric Cardiology Pediatric Dyslipidemia: Angela Gooden MSN, RN, CPNPAC/PC, Texas Children s Hospital, Pediatric Cardiology Objectives Define pediatric dyslipidemia Describe the association between pediatric dyslipidemia

More information

The new guidelines issued in PRESENTATIONS... Future Outlook: Changing Perspectives on Best Practice

The new guidelines issued in PRESENTATIONS... Future Outlook: Changing Perspectives on Best Practice ... PRESENTATIONS... Future Outlook: Changing Perspectives on Best Practice Based on a presentation by Daniel J. Rader, MD Presentation Summary The guidelines recently released by the National Cholesterol

More information

Glossary For TheFatNurse s For All Ages Series Adipocytes, also known as lipocytes and fat cells, are the cells that primarily compose adipose tissue, specialized in storing energy as fat. Apolipoprotein

More information

Behind LDL: The Metabolism of ApoB, the Essential Apolipoprotein in LDL and VLDL

Behind LDL: The Metabolism of ApoB, the Essential Apolipoprotein in LDL and VLDL Behind LDL: The Metabolism of ApoB, the Essential Apolipoprotein in LDL and VLDL Sung-Joon Lee, PhD Division of Food Science Institute of Biomedical Science and Safety Korea University Composition of Lipoproteins:

More information

Dietary fat supplies essential body tissue needs, both as an energy fuel and a structural material.

Dietary fat supplies essential body tissue needs, both as an energy fuel and a structural material. Chapter 3 Fats Chapter 3 Lesson 3.1 Key Concepts Dietary fat supplies essential body tissue needs, both as an energy fuel and a structural material. Foods from animal and plant sources supply distinct

More information

THE CLINICAL BIOCHEMISTRY OF LIPID DISORDERS

THE CLINICAL BIOCHEMISTRY OF LIPID DISORDERS THE CLINICAL BIOCHEMISTRY OF LIPID DISORDERS Hormonal regulation INSULIN lipid synthesis, lipolysis CORTISOL lipolysis GLUCAGON lipolysis GROWTH HORMONE lipolysis CATECHOLAMINES lipolysis LEPTIN catabolism

More information

PLASMA LIPOPROTEINS AND LIPIDS DETERMINATION OF PLASMA CHOLESTEROL AND TRIGLICERIDE LEVEL

PLASMA LIPOPROTEINS AND LIPIDS DETERMINATION OF PLASMA CHOLESTEROL AND TRIGLICERIDE LEVEL PLASMA LIPOPROTEINS AND LIPIDS DETERMINATION OF PLASMA CHOLESTEROL AND TRIGLICERIDE LEVEL Lipids are characterized by low polarity and limited solubility in water. Their plasma concentration is about 500-600

More information

Altered concentrations of blood plasma

Altered concentrations of blood plasma C O N S E N S U S S T A T E M E N T Detection and Management of Lipid Disorders in Diabetes Altered concentrations of blood plasma lipoproteins are powerful predictors of coronary heart disease (CHD) and

More information

Hypertriglyceridemia: Why, When, and How to Treat. Gregory Cohn, MD, FNLA, FASPC

Hypertriglyceridemia: Why, When, and How to Treat. Gregory Cohn, MD, FNLA, FASPC Hypertriglyceridemia: Why, When, and How to Treat Gregory Cohn, MD, FNLA, FASPC DISCLOSURES Consultant to Akcea Therapeutics (in the past 12 months). OUTLINE I. Lipoproteins II. Non-HDL-C III. Causes and

More information

LIPID METABOLISM. Sri Widia A Jusman Department of Biochemistry & Molecular Biology FMUI

LIPID METABOLISM. Sri Widia A Jusman Department of Biochemistry & Molecular Biology FMUI LIPID METABOLISM Sri Widia A Jusman Department of Biochemistry & Molecular Biology FMUI Lipid metabolism is concerned mainly with fatty acids cholesterol Source of fatty acids from dietary fat de novo

More information

CHOLESTAGEL 625 mg Genzyme

CHOLESTAGEL 625 mg Genzyme CHOLESTAGEL 625 mg Genzyme 1. NAME OF THE MEDICINAL PRODUCT Cholestagel 625 mg film-coated tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 625 mg colesevelam hydrochloride (hereafter

More information

Lipoproteins Metabolism

Lipoproteins Metabolism Lipoproteins Metabolism LEARNING OBJECTIVES By the end of this Lecture, the student should be able to describe: What are Lipoproteins? Describe Lipoprotein Particles. Composition of Lipoproteins. The chemical

More information

Diseases & Conditions

Diseases & Conditions http://my.clevelandclinic.org Diseases & Conditions About Cholesterol-Lowering Drugs Some people have a genetic predisposition to high blood cholesterol levels. These people may need drug therapy in addition

More information

March 2005 Current Trends in Treating Elevated Cholesterol H01

March 2005 Current Trends in Treating Elevated Cholesterol H01 W-F Professional Associates, Inc. 400 Lake Cook Rd., Suite 207 Deerfield, IL 60015 847-945-8050 March 2005 Current Trends in Treating Elevated Cholesterol 707-000-05-003-H01 IT S ALWAYS A GOOD IDEA TO

More information

Update in Lipid Management. Rameshkumar Raman M.D. Endocrine Associates of The Quad Cities

Update in Lipid Management. Rameshkumar Raman M.D. Endocrine Associates of The Quad Cities Update in Lipid Management Rameshkumar Raman M.D. Endocrine Associates of The Quad Cities Low-Density Lipoprotein (LDL) Consists of Multiple Distinct Subclasses Differing in Size and Lipid Content* Association

More information

CE Prn. Pharmacy Continuing Education from WF Professional Associates ABOUT WFPA LESSONS TOPICS ORDER CONTACT MCA EXAM REVIEWS

CE Prn. Pharmacy Continuing Education from WF Professional Associates ABOUT WFPA LESSONS TOPICS ORDER CONTACT MCA EXAM REVIEWS CE Prn Pharmacy Continuing Education from WF Professional Associates ABOUT WFPA LESSONS TOPICS ORDER CONTACT MCA EXAM REVIEWS Hyperlipidemia---Update & Review The objectives of this lesson are such that

More information

Cholesterol. Medicines To Help You

Cholesterol. Medicines To Help You Medicines To Help You Cholesterol Use this guide to help you talk to your doctor, pharmacist, or nurse about your cholesterol medicines. The guide lists all of the FDA-approved products now available to

More information

The New Gold Standard for Lipoprotein Analysis. Advanced Testing for Cardiovascular Risk

The New Gold Standard for Lipoprotein Analysis. Advanced Testing for Cardiovascular Risk The New Gold Standard for Lipoprotein Analysis Advanced Testing for Cardiovascular Risk Evolution of Lipoprotein Testing The Lipid Panel Total Cholesterol = VLDL + LDL + HDL Evolution of Lipoprotein Testing

More information

History. Aron first proposed that fat may be essential for normal growth Tested on animals-vitamins A,D,E added. Fat deficiency severely affected

History. Aron first proposed that fat may be essential for normal growth Tested on animals-vitamins A,D,E added. Fat deficiency severely affected Chapter 5 LIPIDS History 1918 Aron first proposed that fat may be essential for normal growth Tested on animals-vitamins A,D,E added Fat deficiency severely affected Bone growth Reproduction Called Vitamin

More information

Factors to Consider in the Study of Biomolecules

Factors to Consider in the Study of Biomolecules Factors to Consider in the Study of Biomolecules What are the features of the basic building blocks? (ex: monosaccharides, alcohols, fatty acids, amino acids) 1) General structure and functional groups

More information

Fibrate and cardiovascular disease: Evident from meta-analysis. Thongchai Pratipanawatr

Fibrate and cardiovascular disease: Evident from meta-analysis. Thongchai Pratipanawatr Fibrate and cardiovascular disease: Evident from meta-analysis Thongchai Pratipanawatr ??? ย คห นใหม ย คห นกลาง ย คห นเก า ?? Statin era? ย คห นใหม ย คห นกลาง ย คห นเก า CURRENT ROLE OF FIBRATE What are

More information

LIPIDS Dr. Latifah Al-Oboudi 2012

LIPIDS Dr. Latifah Al-Oboudi 2012 LIPIDS Dr. Latifah Al-Oboudi 2012 The Lipid Family Triglycerides Phospholipids Sterols All types of lipids are: soluble in organic solvents such as chloroform, benzene, and ether, but not in water. Differ

More information

Lipid Metabolism Prof. Dr. rer physiol. Dr.h.c. Ulrike Beisiegel

Lipid Metabolism Prof. Dr. rer physiol. Dr.h.c. Ulrike Beisiegel Lipid Metabolism Department of Biochemistry and Molecular Biology II Medical Center Hamburg-ppendorf 1 Lipids. visceral fat. nutritional lipids 0 1.5 3 4.5 9 h. serum lipids. lipid accumulation in the

More information

Lipids, lipoproteins and cardiovascular disease

Lipids, lipoproteins and cardiovascular disease Lipids, lipoproteins and cardiovascular disease Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy Cardiovascular disease Plasma enzymes

More information

Lipid/Lipoprotein Structure and Metabolism (Overview)

Lipid/Lipoprotein Structure and Metabolism (Overview) Lipid/Lipoprotein Structure and Metabolism (Overview) Philip Barter President, International Atherosclerosis Society Centre for Vascular Research University of New South Wales Sydney, Australia Disclosures

More information

STATIN UTILIZATION MANAGEMENT CRITERIA

STATIN UTILIZATION MANAGEMENT CRITERIA STATIN UTILIZATION MANAGEMENT CRITERIA DRUG CLASS: HMG Co-A Reductase Inhibitors & Combinations Agents which require prior review: Advicor (niacin extended-release/lovastatin) Crestor (rosuvastatin)(5mg,10mg,

More information

Lipids are used to store and excess energy from extra carbohydrates in animals

Lipids are used to store and excess energy from extra carbohydrates in animals Lipids Lipids are a major source of energy used by cells, however lipids are more difficult for your body to break down. They produce nearly twice the amount of energy than proteins or carbohydrates. Lipids

More information

In the Know: Canadian Guidelines for Dyslipidemia, 2003

In the Know: Canadian Guidelines for Dyslipidemia, 2003 In the Know: Canadian Guidelines for Dyslipidemia, 2003 In his reviews of Canadian dyslipidemia guidelines, Dr. Curnew explores the impact of major trials, the assessment and categories of risk, and both

More information

Nutrition & Wellness for Life 2012 Chapter 6: Fats: A Concentrated Energy Source

Nutrition & Wellness for Life 2012 Chapter 6: Fats: A Concentrated Energy Source Tools: Printer 8.5 x 11 paper Scissors Directions: 1. Print 2. Fold paper in half vertically 3. Cut along dashed lines Copyright Goodheart-Willcox Co., Inc. All rights reserved. Tissue in which the body

More information

High ( 50%) Restrictions mg 20-40mg PA; TS ⱡ 15 ⱡ

High ( 50%) Restrictions mg 20-40mg PA; TS ⱡ 15 ⱡ MEDICATION COVERAGE POLICY PHARMACY AND THERAPEUTICS ADVISORY COMMITTEE POLICY: Cholesterol P&T DATE: 5/9/2017 THERAPEUTIC CLASS: Cardiovascular REVIEW HISTORY: 5/16, 5/15, 2/14, 5/12, LOB AFFECTED: Medi-Cal

More information

PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN

PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN 1980 to 2000: Death rate fell from: 542.9 to 266.8 per 100K men 263.3 to 134.4 per 100K women 341,745 fewer deaths from CHD in 2000 Ford ES, NEJM, 2007 47% from CHD treatments, 44% from risk factor modification

More information

ATP IV: Predicting Guideline Updates

ATP IV: Predicting Guideline Updates Disclosures ATP IV: Predicting Guideline Updates Daniel M. Riche, Pharm.D., BCPS, CDE Speaker s Bureau Merck Janssen Boehringer-Ingelheim Learning Objectives Describe at least two evidence-based recommendations

More information

Approach to Dyslipidemia among diabetic patients

Approach to Dyslipidemia among diabetic patients Approach to Dyslipidemia among diabetic patients Farzad Hadaegh, MD, Professor of Internal Medicine & Endocrinology Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences

More information

Maintain Cholesterol

Maintain Cholesterol Maintain Cholesterol What is Cholesterol? Cholesterol is a Lipid Molecule that has a waxy appearance and is found in every cell of the body and has some important natural functions. It is manufactured

More information

Antihyperlipidemic Drugs Munir Gharaibeh, MD, PhD, MHPE

Antihyperlipidemic Drugs Munir Gharaibeh, MD, PhD, MHPE Antihyperlipidemic Drgs Mnir Gharaibeh, MD, PhD, MHPE School of Medicine, The University of Jordan November, 2017 Antihyperlipidemic Drgs Hyperlipidemias. Hyperlipoproteinemias. Hyperlipemia. Dyslipidemias

More information

BIOLOGY 111. CHAPTER 2: The Chemistry of Life Biological Molecules

BIOLOGY 111. CHAPTER 2: The Chemistry of Life Biological Molecules BIOLOGY 111 CHAPTER 2: The Chemistry of Life Biological Molecules The Chemistry of Life : Learning Outcomes 2.4) Describe the significance of carbon in forming the basis of the four classes of biological

More information

May 2003 Lipid Management H01 HAVE YOU RECENTLY MOVED? PLEASE NOTIFY US.

May 2003 Lipid Management H01 HAVE YOU RECENTLY MOVED? PLEASE NOTIFY US. W-F Professional Associates, Inc. 400 Lake Cook Rd., Suite 207 Deerfield, IL 60015 847-945-8050 May 2003 Lipid Management 707-000-03-005-H01 MISSING A LESSON? IT S EASY TO GO TO OUR WEBSITE & DOWNLOAD

More information

... CPE/CNE QUIZ... CPE/CNE QUESTIONS

... CPE/CNE QUIZ... CPE/CNE QUESTIONS CPE/CNE QUESTIONS Continuing Pharmacy Education Accreditation The Virginia Council on Pharmaceutical Education is approved by the American Council on Pharmaceutical Education as a provider of continuing

More information

Rosuvastatin 5 mg, 10 mg and 20 mg Tablet

Rosuvastatin 5 mg, 10 mg and 20 mg Tablet Rosuvastatin 5 mg, 10 mg and 20 mg Tablet Description is a preparation of Rosuvastatin. Rosuvastatin is a member of the drug class of statins, used in combination with exercise, diet, and weight-loss to

More information

1Why lipids cannot be transported in blood alone? 2How we transport Fatty acids and steroid hormones?

1Why lipids cannot be transported in blood alone? 2How we transport Fatty acids and steroid hormones? 1Why lipids cannot be transported in blood alone? 2How we transport Fatty acids and steroid hormones? 3How are dietary lipids transported? 4How lipids synthesized in the liver are transported? 5 Lipoprotien

More information

Disclosures. Pediatric Dyslipidemia Casey Elkins, DNP, NP C, CLS, FNLA. Learning Objectives. Atherogenesis. Acceptable Values

Disclosures. Pediatric Dyslipidemia Casey Elkins, DNP, NP C, CLS, FNLA. Learning Objectives. Atherogenesis. Acceptable Values 39 th National Conference on Pediatric Health Care Pediatric Dyslipidemia Casey Elkins, DNP, NP C, CLS, FNLA March 19-22, 2018 CHICAGO Disclosures Speakers Bureau Sanofi and Regeneron Learning Objectives

More information

DISLIPIDEMIA. Dharma Lindarto. Div: Endokrinologi-Metabolik. Departemen Ilmu Penyakit Dalam FK USU/RSUP. H Adam Malik Medan

DISLIPIDEMIA. Dharma Lindarto. Div: Endokrinologi-Metabolik. Departemen Ilmu Penyakit Dalam FK USU/RSUP. H Adam Malik Medan DISLIPIDEMIA Dharma Lindarto Div: Endokrinologi-Metabolik. Departemen Ilmu Penyakit Dalam FK USU/RSUP. H Adam Malik Medan Introduction Dyslipidemia is a general term associated with high cholesterol and/or

More information

CHAPTER FORTY FIVE ENDOGENOUS LIPID TRANSPORT PATHWAY: VLDL AND IDL

CHAPTER FORTY FIVE ENDOGENOUS LIPID TRANSPORT PATHWAY: VLDL AND IDL CHAPTER FORTY FIVE ENDOGENOUS LIPID TRANSPORT PATHWAY: VLDL AND IDL You will notice that the endogenous pathway is very similar to the exogenous pathway What is the average daily amount of triacylglycerol

More information

ANSC/NUTR 618 LIPIDS & LIPID METABOLISM The LDL Receptor, LDL Uptake, and the Free Cholesterol Pool

ANSC/NUTR 618 LIPIDS & LIPID METABOLISM The LDL Receptor, LDL Uptake, and the Free Cholesterol Pool ANSC/NUTR 618 LIPIDS & LIPID METABOLISM The, LDL Uptake, and the Free Cholesterol Pool I. Michael Brown and Joseph Goldstein A. Studied families with familial hypercholesterolemia. B. Defined the relationship

More information

An educational booklet for patients with familial hypercholesterolemia DR. LEIV OSE

An educational booklet for patients with familial hypercholesterolemia DR. LEIV OSE An educational booklet for patients with familial hypercholesterolemia DR. LEIV OSE CONTENTS WHAT WILL YOU LEARN FROM THIS BOOKLET? You will learn about Familial Hypercholesterolemia, its cause, and the

More information

ANTI-HYPERLIPIDEMIC AGENTS AND NSAIDS LECTURE 6

ANTI-HYPERLIPIDEMIC AGENTS AND NSAIDS LECTURE 6 ANTI-HYPERLIPIDEMIC AGENTS AND NSAIDS LECTURE 6 HYPERLIPIDEMIA Cholesterol Total cholesterol LDL cholesterol HDL cholesterol men women Triglycerides

More information

Physiology Unit 4 DIGESTIVE PHYSIOLOGY

Physiology Unit 4 DIGESTIVE PHYSIOLOGY Physiology Unit 4 DIGESTIVE PHYSIOLOGY In Physiology Today Functions Motility Ingestion Mastication Deglutition Peristalsis Secretion 7 liters/day! Exocrine/endocrine Digestion Absorption Digestion of

More information

Lipids Board Review. Ira Goldberg, MD New York University School of Medicine. Which of the following is the best initial therapy choice?

Lipids Board Review. Ira Goldberg, MD New York University School of Medicine. Which of the following is the best initial therapy choice? Lipids Board Review Ira Goldberg, MD New York University School of Medicine 1. A 22 year old male college student is referred for severe hypertriglyceridemia ( 1500 mg/dl [ 17.0 mmol/l]). He has a history

More information

Lipid Management: A Case-Based Approach. Overview. Simple Lipid Therapy Approach. Patients have lipid disorders of:

Lipid Management: A Case-Based Approach. Overview. Simple Lipid Therapy Approach. Patients have lipid disorders of: Lipid Management: A Case-Based Approach Patrick E. McBride, M.D., M.P.H. Professor of Medicine, Cardiovascular Medicine Associate Director, Preventive Cardiology Program UW School of Medicine and Public

More information