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pathophysiology pharmacology dyslipidemia primarycare 2013 2017 @dharsaty abnormal accaha acid algorithm amenorrhea atherosclerosis bileacid biliary cardiology causes cholesterol clincal comparison
Mechanism of Action of Bile Acid Sequestrants Bile Acid Sequestrants → ↓ Hepatic Bile Acid Pool →
Expression → ↑ VLDL ... /Secretion → ↑ LDL ... Production → ↑ LDL ... Receptors → ↑ LDL ... Clearance → ↓ Plasma LDL-C
Lipoprotein Metabolism Enterocytes release absorbed lipids the form of triglyceride-rich chylomicrons. These are acted upon by endothelial
lipoproteins (VLDLs ... VLDLs are released ... liproprotein (LDL
#Estrogen 25-OH-D3 formation #HDL #LDL #VLDL Y Proliferation and desquamation of #vaginalepithelium In children: delayed epiphyseal fusion #Osteoporosis Atherosclerosis Vaginal infections Tall stature #Progestogen #mammarygland tubes No buildup of uterus
formation #HDL #LDL ... #VLDL Y Proliferation
Stimulation of glycogenolysis, gluconeogenesis Hyperglycemia Accelerated breakdown of VLDL and LDL, stimulation of bile secretion VLDL + Cholesterol Energy metabolism† 02 con- sumption Heat metabolism
breakdown of VLDL ... and LDL, stimulation ... bile secretion VLDL
Depostion of glycosamineglycans (mucin) Filtration of albumin Nat retention + < Edema Effusion, hoarse voice, puffed-up face Impaired cerebral development Myxedema Neuromuscular excitability Sensory disturbances Hyporeflexia Lack of drive Depression Clouded
Delayed breakdown of VLDL ... bile secretion VLDL
ACC/AHA Statin Guidelines - 2013 vs 2017 In 2013 the ACC/AHA guidelines drastically changed the way we
the traditional LDL ... group, if the LDL ... alternatively use the LDL ... of the target LDL ... expect a >50% LDL
Prescription Fish Oils Prescription fish oils, Lovaza, and Vascepa, are commonly used for treatment of hypertriglyceridemia (TG
of increasing LDL ... without effect on LDL
Risk factors for atherosclerosis Modifiable risk factors: - Dyslipidemia (elevated LDL, decreased HDL) - Tobacco smoking -
Dyslipidemia (elevated LDL
Abnormal Lipid Profiles - Differential Diagnosis Algorithm Increased Cholesterol and Triglycerides - Genetic Causes
Androgens Increased LDL
Fibrates - Gemfibrozil and Fenofibrate Mechanism: activates PPAR alpha Lipid Effects: - Decrease TG by 30-50% -
- Decrease LDL
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