Chapter 20: Drug Therapy of Dyslipidemias

INTRODUCTION

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:

• 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

LEARNING OBJECTIVES

• 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.