Real Life Pharmacology - Pharmacology Education For Health Care Professionals

Miscellanous Cholesterol Agents – Test Prep and Practice Pearls

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Sinopsis

In this episode, we explore several important non-statin cholesterol-lowering therapies, focusing on their mechanisms, clinical uses, and practical considerations for patient care. We start with bile acid sequestrants, also known as resins, including cholestyramine, colestipol, and colesevelam. These medications lower LDL cholesterol by binding bile acids in the gut, prompting the liver to use more cholesterol to make new bile acids. They are effective for LDL reduction but may cause gastrointestinal side effects and have drug interaction considerations. Next, we cover niacin (vitamin B3), which can lower LDL and triglycerides while raising HDL cholesterol. While niacin was historically widely used, its role has declined due to flushing, gastrointestinal symptoms, and potential liver toxicity. Omega-3 fatty acids, including icosapent ethyl (EPA), primarily lower triglycerides and are used in patients with severe hypertriglyceridemia to reduce the risk of pancreatitis. Icosapent ethyl is a purified EPA formula