Hyperlipidemia

Detail on Hyperlipidemia disease

1. HYPERLIPIDEMIA NAME: SHOUVIK KUMAR NANDY SUBJECT :- M.PHARM (PHARMACOLOGY) ADVANCE PHARMACOLOGY I NAME: PRIYANKA SAGAR NEGI SUBJECT :- M.PHARM (PHARMACOLOGY) ADVANCE PHARMACOLOGY I

2. Contents :- Definition Pathophysiology Diagnosis Causes Types of hyperlipidemia Symptoms of hyperlipidemia Prevention of disease Drugs of treatment on hyperlipidemia Mechanism of action of drugs Side effects of drugs Reference

3. WHAT IS HYPERLIPIDEMIA ? Hyperlipidemia is a family of disorders that are characterized by abnormally high level of lipid (fats) in blood. High blood levels of fats increase the risk of coronary heart disease (CHD). Two common lipid abnormalities are characterized either by high blood cholesterol level (hypercholesterolemia) or high blood levels of triglycerides (hypertriglyceridemia). Cholesterol present is blood vessels

4. Pathophysiogy:- Chylomicrons transport fats from the intestinal mucosa to the liver. In the liver, the chylomicrons release two types of lipoproteins, that transport cholesterol to the cells: Low-density lipoproteins(LDL), or bad cholesterol, and high-density lipoproteins(HDL), or good cholesterol. LDL has damaging effects on health. HDL, however, counteracts the effects of LDL. HDL carries excess cholesterol back to the liver for excretion.

5. Diagnosis:- Fasting lipoprotein profile ( FLP ) including total cholesterol, LDL, HDL, & triglycerides should be measured in all adults 20 years of age or older at least once every 5 years. Measurement of plasma cholesterol, triglyceride & HDL levels after a 12 hours or longer fast is important.

6. CAUSES OF HYPERLIPIDEMIA:- A diet high in saturated fat & cholesterol increases blood cholesterol and triglyceride level. Obesity increases the risk of hyperlipidemia. Steroid uses, excessive alcoholism, hypothyroidism, chronic renal failure are the reason of hyperlipidemia. Pregnancy may responsible for it. Long term kidney disease may cause hyperlipidemia.

7. TYPES OF HYPERLIPIDEMIA HYPERLIPOPROTEINEMIA SYNONYMS INCREASED LIPOPROTEIN TREATMENT Type I (rare) Familial hyperchylomicronemia Chylomicrons Diet control Type IIa Familial hypercholesterolemia LDL Bile acid sequestrants, statins, niacin Type IIb Combined hyperlipidemia LDL and VLDL Statins, niacin, fibrate Type III (rare) Familial dysbetalipoproteinemia IDL Fibrates, statins Type IV Familial hyperlipidemia VLDL Fibrate, niacin, statins Type V (rare) Familial mixed hypertriglyceridemia VLDL and chylomicrons Niacin, Fibrate

8. SYMPTOMS OF HYPERLIPIDEMIA Develop yellow, fatty growths around the eyes or joints. For coronary heart disease (CHD) or atherosclerosis at the other sites, symptoms may include chest pain (Angina), heart attack, or stroke. Very high triglyceride levels may result in the formation of nodules on the elbows or knees. Swelling of organs such as the liver, spleen or pancreas.

9. Symptoms by hyperlipidemia

10. PREVENTION OF HYPERLIPIDEMIA Eat a diet low in saturated fats & cholesterol to prevent lipid abnormalities. Eat food high in soluble fiber such as oats, beans, peas & certain fruits. Exercise regularly. Maintain a healthy weight or loss weight if necessary. Moderate alcohol consumption ( Which increases levels of HDL cholesterol, which decrease the risk of coronary heart disease).

11. Drugs for Hyperlipidemia Class of drug Agents Side effect HMG CoA reductase inhibitors Lovastatin Pravastatin Myopathy, increased liver enzymes Cholesterol absorption inhibitor Ezetimibe Headache, GI distress Nicotinic Acid Niacin Flushing, Hyperglycemia, Hyperuricemia, GI distress Fibric acid Gemfibrozil Fenofibrate Dyspepsia, Gallstones Bile Acid sequestrants Cholestyramine GI distress, constipation, decreased absorption of other drugs.

12. MECHANISM OF ACTION :- Fig:- Inhibition of HMG CoA reductase by the statin drugs.

13. MECHANISM OF ACTION of FIBRATES :- Hydrolysis of VLDL & chylomicron Triglyceride Clearance of LDL by liver & increase HDL

14. MECHANISM OF ACTION of NICOTINIC ACID:- Adipose tissue Niacin Triglyceride Fatty Acid Triglyceride VLDL LDL Inhibit lipolysis in adipose tissue decrease the VLDL & LDL

15. Mechanism of action of Bile acid Sequestrants:- Drug Bile acid (small intestine) Formation of bile acid complex Decrease the bile acid in stools Increase the conversion of cholesterol into bile acid in liver Decrease the concentration & hepatic cholesterol Increase LDL receptor Increase the hepatic uptake of LDL Decrease serum LDL cholesterol.

16. Side effects of drugs:- Myositis ( inflammation of muscles). Headache Difficulty sleeping Flushing of skin Drowsiness Diarrhea Constipation Rash Statins also carry warning that memory loss, mental confusion, high blood sugar .

17. REFERENCE Sharma V N, Essential of pharmacology, 3 rd edition, CBS Publishers & Distributors. New Delhi, Bangalore pg. no:- 267-285. Katzung Bertram G. , Basic & clinical Pharmacology, 6 th edition, Appleton & Lange Norwalk, Connecticut. Pg. no:- 523-534. Barar F.S.K, Essentials of pharmacotherapeutics, 1 st edition, S.Chand & company LTD. Pg. no:- 298-301. Lippincott, Illustrated Reviews Pharmacology, 6 th edition, Wolter Kluwer, New Delhi, New York, London, hong Kong, Tokyo. Pg. no:- 311-320

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