Batch 3: Lipids & Angina

Lipid Lowering Agents

• Statins: Inhibit HMG-CoA Reductase. Lower LDL.
  SE: Myopathy (check CK), Hepatotoxicity (check LFTs).
• Fibrates (Gemfibrozil): Activate PPAR-alpha. Lower TGs.
  SE: Cholesterol Gallstones, Rhabdo (if w/ Statin).
• Ezetimibe: Blocks cholesterol absorption at intestinal brush border.
• PCSK9 Inhibitors: Prevent degradation of LDL receptors -> More receptors clear LDL.
• Bile Resins (Cholestyramine): Bind bile acids.
  SE: GI upset, Fat-soluble vitamin (A,D,E,K) deficiency.
• Niacin: Raises HDL.
  SE: Flushing (Prostaglandins - fix w/ Aspirin), Hyperglycemia/Gout.

Anti-Anginals

• Nitrates: Venodilation (Decrease Preload/LVEDV).
  SE: Reflex Tachycardia, Tolerance (Needs nitrate-free interval). Contraindicated w/ Sildenafil.
• Ranolazine: Inhibits Late Na+ current. Decreases wall tension. No HR/BP effect. QT prolongation.
• Ivabradine: Inhibits Funny current (If). Slows HR.
  SE: Luminous phenomena.