Of hyperlipidemia

Nicotinic acid is used in the treatment of hyperlipidemia. It causes various changes in lipid and lipoprotein metabolism when administered in high doses (up to 5 g/d) ... 

Hyperlipidemia, particularly elevated serum cholesterol and LDL levels, is a risk factor in the development of atlierosclerotic heart disease. Other risk factors, besides cholesterol levels, play a role in the development of hyperlipidemia. Additional risk factors include ... 

While the fibric acid derivatives have antihyperlipidemic effects, their use varies depending on the drug. For example, Clofibrate (Atromid-S) and gemfibrozil (Lopid) are used to treat individuals with very high serum triglyceride levels who present a risk of abdominal pain and pancreatitis and who do not experience a response to diet modifications. Clofibrate is not used for the treatment of other types of hyperlipidemia and is not thought to be effective for prevention of coronary heart disease. Fenofibrate (Tricor) is used as adjunctive treatment for the reduction of LDL, total cholesterol, and triglycerides in patients with hyperlipidemia. 

The nurse takes a dietary history, focusing on the types of foods normally included in the diet. Vital signs and weight are recorded. The skin and eyelids are inspected for evidence of xanthomas (flat or elevated yellowish deposits) that may be seen in the more severe forms of hyperlipidemia. 

Hyperlipidemia plays a role in the development of cardiovascular disease (CVD) in patients with CKD. The primary goal of treatment of dyslipidemras is to decrease the risk of atherosclerotic cardiovascular disease. A secondary goal in patients with CKD is to reduce proteinuria and decline in kidney function. Treatment of hyperlipidemia in patients with CKD has been demonstrated to slow the decline in GFRby 1.9 mL/minute per year of treatment with antihyper Epidemic agents.21... 

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... 

Primary or genetic lipoprotein disorders are classified into six categories for the phenotypic description of dyslipidemia. The types and corresponding lipoprotein elevations include the following I (chylomicrons), Ha (LDL), lib (LDL + very low density lipoprotein, or VLDL), III (intermediate-density lipoprotein), IV (VLDL), and V (VLDL + chylomicrons). Secondary forms of hyperlipidemia also exist, and several drug classes may elevate lipid levels... 

A complete history and physical examination should assess (1) presence or absence of cardiovascular risk factors or definite cardiovascular disease in the individual (2) family history of premature cardiovascular disease or lipid disorders (3) presence or absence of secondary causes of hyperlipidemia, including concurrent medications and (4) presence or absence of xanthomas, abdominal pain, or history of pancreatitis, renal or liver disease, peripheral vascular disease, abdominal aortic aneurysm, or cerebral vascular disease (carotid bruits, stroke, or transient ischemic attack). 

Nicotinamide should not be used in the treatment of hyperlipidemia because it does not effectively lower cholesterol or triglyceride levels. 

In patients treated for secondary intervention, symptoms of atherosclerotic cardiovascular disease, such as angina or intermittent claudication, may improve over months to years. Xanthomas or other external manifestations of hyperlipidemia should regress with therapy. 

Patient case A patient s daily nutritional requirements have been estimated to be 100 g protein and 2,000 total kcal. The patient has a central venous access and reports no history of hyperlipidemia or egg allergy. The patient is not fluid restricted. The PN solution will be compounded as an individualized regimen using a single-bag, 24-hour infusion of a 2-in-1 solution with intravenous fat emulsion (IVFE) piggybacked into the PN infusion line. Determine the total PN volume and administration rate by calculating the macronutrient stock solution volumes required to provide the desired daily nutrients. The stock solutions used to compound this regimen are 10% crystalline amino acids (CAA), 70% dextrose, and 20% IVFE. 

The prevalence of hyperlipidemia increases as renal function declines. 

Koro CE, Fedder IX), L ltalien GJ, et al. An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients. Arch Gen Psychiatry 2002 59 1021-6. 

Treatment of hyperlipidemia is based on the assumption that lowering serum lipids decreases morbidity and mortality of atherosclerotic cardiovascular disease. 

Hyperlipidemia, secondary causes Prior to initiating therapy, exclude secondary causes of hyperlipidemia (eg, poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemias, obstructive liver disease, other drug therapy, alcoholism) and measure total-C, HDL-C, and triglycerides. 

The combination of amprenavir and low-dose ritonavir has been associated with elevations of cholesterol and triglycerides, AST, and ALT in some patients. Consider appropriate laboratory testing prior to initiating combination therapy with amprenavir and ritonavir and at periodic intervals, or if any clinical signs or symptoms of hyperlipidemia or elevated liver function tests occur during therapy. 

To treat hyperuricemia associated medical problems the following steps are recommended life-style corrections by restriction of purine-rich nutrition, prevention and reduction of obesity, bloodpressure control, limitation of alcohol consumption and control of hyperlipidemia. 

The answer is a. (Hardman, pp 875-898.) In type I hyperlipoproteinemia, drugs that reduce levels of lipoproteins are not useful, but reduction of dietary sources of fat may help. Cholesterol levels are usually normal, but triglycerides are elevated. Maintenance of ideal body weight is recommended in all types of hyperlipidemia. Clofibrate effectively reduces the levels of VLDLs that are characteristic of types 111, IV, and V hyperlipoproteinemia administration of cholestyramine resin and lovastatin in conjunction with a low-cholesterol diet is regarded as effective therapy for type 11a, or primary, hyperbetalipoproteinemia, except in the homozygous familial form. 

These drugs are used for treatment of hyperlipidemia. They lower the levels of lipoproteins and lipids in blood. The plasma lipids are present in lipoproteins after combining with apoproteins. They are high density lipoproteins (HDL), low density lipoproteins (LDL), very low density lipoproteins (VLDL) and intermediate density lipoproteins (IDL). 

Is an indigenous drug obtained from gum guggul used for treatment of hyperlipidemia, hypercholesterolemia and hypertriglyceridemia. 

The two major clinical sequelae of hyperlipidemias are acute pancreatitis and atherosclerosis. The former occurs in patients with marked hyperlipemia. Control of triglycerides can prevent recurrent attacks of this life-threatening disease. 

Although treatment of hyperlipidemia can cause slow physical regression of plaques, the well-documented reduction in acute coronary events that follows vigorous lipid-lowering treatment is attributable chiefly to mitigation of the inflammatory activity of macrophages and is evident within 2-3 months after starting therapy. 

All PI agents, with the possible exception of fosamprenavir, carry the risk of hyperlipidemia, fat maldistribution, hyperglycemia, and insulin resistance as a potential adverse event. 

In a common case of hyperlipidemia, herbal formulas can be composed and used alongside western drugs. It should be possible to regulate the Liver,... 

The results of the lipoprotein electrophoresis have to be interpreted in the context of other lipid parameters, like plasma total cholesterol and triglyceride levels. Patients with normal cholesterol and triglyceride values may sometimes show electrophoresis patterns that resemble pathologic patterns but should not be classified as such. For untreated type III patients, plasma total cholesterol levels should range from 7.5 to 13.0 mmol/1 and triglycerides from 3.5 to 10.5 mmol/1. The presence of a broad-ji-band in the absence of hyperlipidemia excludes familial dysbetalipoproteinemia (type III). 

Fibrate monotherapy of hyperlipidemia may predispose to rhabdomyolysis with acute renal insufficiency. Patients using fibrates should be cautioned regarding strenuous exertion, dehydration, and the need for prompt evaluation of myalgia. 

Prolonged administration of nicotinic acid can have a diabetogenic effect and decompensation of previously stable diabetes can occur. Severe hyperglycemia has been precipitated by nicotinic acid treatment of hyperlipidemia (24). 

Goldberg A, Alagona DP Jr, Capuzzi DM, Guyton J, Morgan JM, Rodgers J, Sachson R, Samuel P. Multiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemia. Am J Cardiol 2000 85 1100-5. 

---