Hyperlipidemia approach

A patient in the medical clinic is taking cholestyramine (Questran) for hyperlipidemia. The primary health care provider has prescribed TLC for the patient. The patient is on a low-fat diet and walks daily for exercise. His major complaint at this visit is constipation, which is very bothersome to him. Discuss how you would approach this situation with the patient. What information would you give the patient concerning his constipation ... 

The role of RANTES has been further elucidated through the use of mouse models via three approaches (i) induction of hyperlipidemia with a high-fat... 

Talbert RL. Hyperlipidemia. In DiPiro JT, et al, eds. Pharmacotherapy A Pathophysiologic Approach. 5th ed. New York McGraw-Hill 2002. 

Historically, lipoprotein phenotypes reflecting lipoprotein metabolic disorders were classified according to Fredrickson and co-workers. However, these disorders are more rationally approached based on the four metabolic pathways discussed previously (see Figures 26-18 through 26-21). Defects in these pathways, leading to hyperlipidemia, may be related to (1) increased production of lipoproteins, (2) abnormal intravascular processing (e.g., enzymatic... 

Indirect ISE methods dilute the sample in a diluent of fixed high ionic strength so that for Na, the activity coefficient approaches a value of 1. Under these circumstances, the measurement of activity, a (where a = y x concentration, and y is the activity coefficient), is tantamount to measurement of concentration. Flame photometry measures emission of a specific ion after dilution in solutions of high reference ion concentration so that specific emission is also tantamount to the measurement of concentration of the specific ion in total plasma volume. It is the dilution of total plasma volume and the assumption that plasma water volume is constant that render both indirect ISE and flame photometry methods equally subject to the electrolyte exclusion effect. In certain settings, such as ketoacidosis with severe hyperlipidemia or multiple myeloma with severe hyperproteinemia, the negative exclusion effect may be so large that laboratory results lead clinicians to believe that electrolyte concentrations are normal or low when, in fact, the concentration in the water phase may be high or normal, respectively. 

The most common causes of the electrolyte exclusion effect leading to pseudohyponatremia or pseudohypokalemia are hyperlipidemia and hyperproteinemia. In severe hypoproteinemia, the effect works in reverse, resulting in a falsely high (2% to 4%) Na" or value. Several approaches have been proposed to improve the physiological accuracy of electrolyte values determined by methods... 

Cyclosporine inhibits the metabolism of Ever, requiring Ever dose reduction when co-administered with CyA simultaneous administration of CyA and Ever is expected to be the usual approach to immunosuppression. Ever does not affect CyA metabolism. The primary side effect of concern with Ever therapy is hyperlipidemia. ... 

The best approach to the treatment of hyperlipidemia in patients with nephrotic syndrome is to induce remission of the disease (see Chap. 47), or at least to reduce urine protein excretion by aggressive treatment of concurrent hypertension and/or administration of ACEIs or ARBs. Several trials have assessed the effect of L-carnitine supplementation on abnormal lipid metabolism in dialysis patients, but results have been contradictory. ... 

Recently, it has been reported that cancer, arteriosclerosis and coronary heart diseases have long been considered major contributors to morbidity and mortality in developed countries. Many medicinal plants and foodstuffs are used for their preventive effects against life-style-related diseases, such as coronary heart diseases, hypertension, thrombosis, allergic inflammation, arteriosclerosis, hyperlipidemia, and cancer. Although based on the classic concept of Diet and Medicine from the Same Source , as described in old Chinese and Japanese medical books, evidence based on clinical and experimental results were not yet clear. I have been using biochemical and pharmacological approaches to study... 

Therapy - The prevailing therapeutic approach to athero-s clerosis focuses on the treatment of hyperlipidemia, hypertension, obesity, diabetes and other associated pathologies. 

Clinical management of hyperlipidemia has been discussed in two well written manuscripts by authors with extensive experience.Their concepts should be borne in mind by all researchers in the atherosclerotic drug field. Proper dietary management is the primary approach and is essential to successful therapy. In fact most therapeutic failures are due to the inability of the patient to follow the prescribed diet. The diets used are directed toward reduction of obesity and replacement of meat and other saturated fat products with foods containing unsaturated fats and nonmeat high protein substances. 

It is a fallacy to believe that individuals with risk factors for cardiovascular events like smoking, hypertension, or hyperlipidemia can neutralize or minimize their adverse effects by exercise. In the Seven Countries Study (23,24), Finland had the highest overall prevalence of coronary heart disease. The Finnish population consumes large amounts of animal fat. Fiimish lumberjacks are an example of physically active people in whom the risk for coronary heart disease remains high (25). The approach to prevent coronary heart disease should be multifaceted... 

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