March 24, 2023

🩹 Dermatology Course:

Welcome back in this video we’ll talk about all the lipid-lowering agents for your step 1 exam including state ins for braids cultural reasons all of them first we’ll have to memorize the lipid profiles and i’ve put them here in a very simple way these are very important don’t go to your exam without memorizing them and let’s start with the most famous and most

Important lipid lowering agent statins some people call them statins i just call them statins these are the medications ending with a supplicating and they work by inhibiting the hmg coenzyme reductase which normally makes cross-draw it’s a lipid lowering agent so we use it to decrease lipid profile if it was very high but most importantly you will use it as

A secondary prevention for all patients with coronary artery diseases regardless of their lipid profile remember secondary prevention means that we use it after the symptoms occur because primary prevention is the use before symptoms occur the most important side effects are hepatotoxicity a myopathy the cause muscle damage especially when used with vibrates

Or niacin so before prescribing satans make sure to look for the liver function test and ck levels next we have ferb rates these are the medications ended with the subjects curb rate they work by stimulating the pper alpha gene which synthesizes hdl they also increase the lipoprotein lipase which clues triglycerides so we use for breads and patients with higher

Triglyceride levels the most important side effect is that the costco straw gall stones they do that by inhibiting cholesterol hydroxylase which normally makes bile which normally decreases go stones next we have niacin or vitamin b3 and it works by inhibiting the hormone sensitive lipase which inhibits lipolysis which decreases free fatty acid release it mainly

Decreases vldl the side effects for niacin are very important it causes flushing which increases by drinking hot liquids like coffee and decreases by long-term use or nsaids it also increases uric acid in the blood and increases glucose in the blood as well next we have bile acid resins these are the medications starting with kali there are sometimes referred

To as cationic exchange resins so don’t get confused if you say that from the name we can get the function there are resins so they inhibit the while i said the reabsorption in the small intestine normally this policy will be reabsorbed back into the liver and reused again and again so once we inhibit they reused deliver will have to make new bile acid by using

Cholesterol and that’s how it lowers cholesterol they’re mainly used to decrease ldls but they can increase triglyceride these medications will inhibit the reabsorption of all lipid soluble vitamins and medications because they depend on the reabsorption of bile acid and finally we have the pcsk9 inhibitors these are antibodies so they can enter the sub likes map

And they prevent the degradation of the ldl receptor in the liver so the ldl receptor will keep taking more and more ldl from the blood and that’s why they’re mainly used as an ldl decreasing agent the main side effect is seen as symptoms so look for delirium confusion dementia etcetera

Transcribed from video
Statins, Fibrates, and Bile Acid Sequestrants – Mechanism of Action, Indications, and Side Effects By USMLE pass