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INTRODUCTION

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This chapter will be most useful after having a basic understanding of the material in Chapter 31, Drug Therapy for Hypercholesterolemia and Dyslipidemia in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition contains:

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  • Table 31-1 Characteristics of Plasma Lipoproteins which lists the major classes of lipoproteins and their properties

  • Table 31-2 Apolipoproteins which describes the properties and functions of apolipoproteins that have well-defined roles in plasma protein metabolism

  • Table 31-6 Assessing 10-Year Risk of CVD Events which provides an algorithm for estimating a patient’s risk of a cardiovascular disease (CVD) event (ie, myocardial infarction [MI], stroke, transient ischemic attack [(TIA)], peripheral vascular disease, heart failure)

  • Table 31-8 Clinical Identification of the Metabolic Syndrome which provides levels of the five CHD risk factors that define metabolic syndrome

  • Table 31-9 Guidelines Based on the LDL-C and Total Cholesterol:HDL-C Ratio for Treatment of Low HDL-C Patients which provides an algorithm for treating patients with low high-density lipoprotein cholesterol (HDL-C) levels

  • Table 31-10 Dose (mg) of Stains Required to Achieve Various Reductions in Low-Density-Lipoprotein Cholesterol From Baseline which provides an algorithm for initiating dosing of statins based on baseline low-density lipoprotein cholesterol (LDL-C) levels

  • The molecular structures of drugs used to treat dyslipidemias

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LEARNING OBJECTIVES

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  • Understand the mechanisms of action of drugs used to treat dyslipidemia.

  • Know the untoward effects of drugs used to treat dyslipidemias.

  • Know which patients with dyslipidemias should be treated and when treatment should be initiated.

  • Know which drugs are most effective in treating patients with different dyslipidemias.

  • Know which drugs can be used in combination to treat dyslipidemias.

  • Know the effects of treatment on lowering the 10-year risk of a CVD event, and how to set treatment goals based on primary and secondary prevention of a CVD event.

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DRUGS INCLUDED IN THIS CHAPTER

  • Atorvastatin (LIPITOR)

  • Bezafibrate (not marketed in the United States)

  • Cholestyramine (QUESTRAN, CHOLYBAR, others)

  • Ciprofibrate (not marketed in the United States)

  • Clofibrate (no longer available)

  • Colesevelam (WELCHOL)

  • Colestipol (COLESTID, others)

  • Ezetimibe (ZETIA)

  • Ezetimibe/simvastatin (VYTORIN)

  • Fenofibrate (TRICOR, TRIGLIDE)

  • Fluvastatin (LESCOL)

  • Gemfibrozil (LOPID)

  • Lovastatin (MEVACOR)

  • Niacin (NIACOR, NIASPAN, others)

  • Pitavastatin (LIVALO)

  • Pravastatin (PRAVACHOL)

  • Rosuvastatin (CRESTOR)

  • Simvastatin (ZOCOR)

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Table Graphic Jump Location
MECHANISMS OF ACTION OF DRUGS USED TO TREAT DYSLIPIDEMIAS

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