B4 Pharm Exam 1

B4 Pharm Exam 1 How hyperlipidemia leads to heart failure - hyperlip --> athero --> CHD (ie. angina, MI) and/or HTN --> heart failure Classes of Antihyperlipidemic Drugs - - HMG-CoA reductase inhibs (statins) - Bile acid sequestrants - Chol absorp inhibs - Fibrates - Niacin - Others incl PCSK9 inhibs, HDL elevs, HoFH Lipoprotein - transp form of lipids made up of lipids+prots since lipids insol in plasma Chylomicrons - lipoprot synth in intest made of dietary (exog) TGs+chol; most imp apoprot = ApoB-48 VLDL - lipoprot synth in liver made up of endog/hep TGs; most imp apoprot = ApoB-100 IDL - lipoprot synth from VLDL catab made up of chol esters+endog TGs; most imp apoprot = ApoB-100 LDL - lipoprot synth from VLDL catab expr in liver+intest, made up of chol esters; most imp apoprot = ApoB-100 HDL - lipoprot synt in intest, liver, plasma made up of phospholips+chol esters; most imp apoprot = ApoA LDL structure - core of chol esters + outer layer of ApoB-100, phospholipids, free chol mols Relationship of Lipoprotein Size & Density - largest lipoprot (chylomicrons) has lowest density; highest dens = Lp(a) & HDL Exogenous Pathway of Lipid Metabolism - 1). Diet TGs+chol incorp into large chylomic lipoprots 2). Chylomics hydr by LPL on endoth surf adip+musc, cleaving FAs from TGs 3). Chylomic enters circ as predom chol (chylomic remnant) 4). Chylomic remnant into liver by rec-med endocyt Endogenous Pathway of Lipid Metabolism - 1). Liver secr TGs+chol in VLDL form, metab by LPL --> IDL 2). Chol dens in IDL incr until LDL form 3). LDL into liver/periph tiss by LDLR or accum in BVs (athero) 4). HDL prom chol rem from periph cells, tx to apoprot --> deliv back to liver for metab/excr