Endocrinology Question 6 Instructor

List the five classes of lipid–lowering drugs, mechanisms of action, major side effects, and their impact on lipids.

Type of drug Mechanism of action Major side effects Impact on lipids
(rosuvastatin, atorvastatin*, simvastatin*, lovastatin*, pravastatin, fluvastatin)
HMG CoA reductase inhibitor Myositis (<0.1%)
Rhabdomyolysis (<0.01%)
Increased LFT (2-3%)
CYP3A4 inhibition*
LDL: 25-60%
Atorvastatin and Rosuvastatin: TG lowers: 15-33%
(gemfibrozil, fenofibrate, bezafibrate)
PPAR α-agonist GI, skin rash TG: 30-50%
Ezitimibe Cholesterol absorption inhibitor LDL: 18%
Nicotinic acid Decreases FFA flux Flushing
Increased LFTs
HDL: 30-35%
TG, LDL: 20%
Bile acid sequestrants, colesteryramine Bile acid absorption inhibitor Constipation LDL: 25%
TG if already high

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