What is hyperlipidemia (high cholesterol levels)?
Oct 27, 2021 · Hyperlipidemia is a medical term for abnormally high levels of fats (lipids) in the blood, which include cholesterol and triglycerides. Although hyperlipidemia can …
What are the limitations of statins in the treatment of hyperlipidemia?
Jun 21, 2017 · Statins are the mainstay treatment for hyperlipidemia; however, the limitations of statins include treatment resistance, intolerance due to adverse events, and a lack of adherence which contribute ...
Can hyperlipidemia medications be combined with other medications?
Jan 15, 2017 · If 40 to 75 years of age with diabetes and LDL-C of 70 to 189 mg per dL (1.81 to 4.90 mmol per L), use a moderate-intensity statin (unless 10-year ASCVD risk ≥ 7.5%, in which case use a high ...
What are the adjunct therapies for hyperlipidemia?
Although dietary changes should always be included in the treatment of hyperlipidemias, the length of time given to lifestyle changes prior to initiation of pharmacotherapy remains controversial. In patients with low cardiovascular risk, it has been proposed that the efficacy of dietary and other lifestyle changes can be assessed in two to three visits over a two- to three …
Which type of medication is administered to combat hyperlipidemia?
Statins are the most commonly prescribed lipid-lowering agents because they are effective, well tolerated and easy to administer.Jun 1, 2000
Which of the following types of medications causes the pupils to dilate during an ophthalmic exam?
Description and Brand Names Tropicamide is used to dilate (enlarge) the pupil so that the doctor can see into the back of your eye. It is used before eye examinations, such as cycloplegic refraction and examination of the fundus of the eye. Tropicamide may also be used before and after eye surgery.Feb 1, 2022
Which of the following is an example of a keratolytic agent?
Such agents (keratolytics) include alkali (by swelling and hydrolysis of skin), salicylic acid, urea, lactic acid, allantoin, glycolic acid, and trichloroacetic acid.
Which preparation is used to prevent an infant from developing diaper rash?
Apply a thick layer — like icing a cake — of diaper rash cream or ointment that contains petroleum jelly or zinc oxide. It will keep your baby's delicate skin protected by forming a barrier against moisture.Jul 11, 2021
What drugs cause dilated pupils?
Stimulants and psychotropic substances most commonly cause pupil dilation. However, this symptom can result from ingesting alcohol, mescaline, cocaine, ecstasy, LSD, psilocybin, MDMA, amphetamines, cannabis, inhalants, narcotics, hallucinogens, bath salts, ketamine, and SSRI antidepressants.Mar 17, 2020
What causes pupils to dilate?
Muscles in the colored part of your eye, called the iris, control your pupil size. Your pupils get bigger or smaller, depending on the amount of light around you. In low light, your pupils open up, or dilate, to let in more light. When it's bright, they get smaller, or constrict, to let in less light.Nov 29, 2021
Which of the following disorders would be treated with a keratolytic agent?
Salicylic acid has keratolytic properties and is applied topically for the treatment of hyperkeratotic and scaling skin conditions such as dandruff and seborrheic dermatitis, ichthyosis, psoriasis, and acne.
What is glucocorticoid keratolytic used for?
Corticosteroid / keratolytic combinations are used to treat psoriasis, eczema, skin allergies, and itching. They work by moisturizing the skin and reducing swelling, itching, and redness of the skin.
Which among the following drug acts as a keratolytic in fungal infection?
Salicylate and carbamide preparations Salicylates are used as keratolytics in concentrations of 2–10% or 30–50% (i.e. in solutions or vaseline for therapy of verrucae vulgares (warts). Carbamide preparations are used in 10% solutions.
How do you treat diaper rash?
Use diapers that are larger than usual until the rash goes away.Applying ointment, paste, cream or lotion. Various diaper rash medications are available without a prescription. Talk to your doctor or pharmacist for specific recommendations. ... Bathing daily. Until the rash clears up, give your baby a bath each day.Apr 7, 2020
How can I prevent diaper rash?
PreventionChange diapers often. ... Rinse your baby's bottom with warm water as part of each diaper change. ... Gently pat the skin dry with a clean towel or let it air dry. ... Don't overtighten diapers. ... Give your baby's bottom more time without a diaper. ... Consider using ointment regularly.More items...•Apr 7, 2020
How do you treat a rash on a baby?
Diaper Rash TreatmentsCream or ointment with zinc oxide or petrolatum (petroleum jelly). Smooth it onto your baby's clean, dry bottom before putting on a clean diaper.Baby powder. ... Antifungal cream, if your baby has a fungal infection.Topical or oral antibiotics, if your baby has a bacterial infection.Jul 29, 2020
What are the side effects of keratolytic agents?
1. Keratolytic agents are used to promote the formation of the horny layer of skin. 2. Local side effects of keratolytic agents include burning and local irritation. 3. Keratolytic agents promote shedding of warts, calluses, and corns.
Does sunscreen cause premature aging?
Sunscreens have no effect on premature aging or in precancerous conditions, although these products do prevent cancer. Topical creams and ointments for pediculosis should be applied to the affected area and left on for 12 hours, and then the area should be thoroughly washed. true.
How to tell if you have hyperlipidemia?
Hyperlipidemia has no symptoms, so the only way to detect it is to have your doctor perform a blood test called a lipid panel or a lipid profile. This test determines your cholesterol levels. Your doctor will take a sample of your blood and send it to a lab for testing, then get back to you with a full report. Your report will show your levels of:
What is the name of the condition that causes high cholesterol and high triglycerides?
It’s called familial combined hyperlipidemia. Familial combined hyperlipidemia causes high cholesterol and high triglycerides. People with this condition often develop high cholesterol or high triglyceride levels in their teens and receive a diagnosis in their 20s or 30s. This condition increases the risk of early coronary artery disease and heart attack.
What is the term for a high level of fat in the blood?
Hyperlipidemia is a medical term for abnormally high levels of fats (lipids) in the blood. The two major types of lipids found in the blood are triglycerides and cholesterol. Triglycerides are made when your body stores the extra calories it doesn’t need for energy.
What is considered high cholesterol?
Generally, a total cholesterol level above 200 milligrams per deciliter is considered high. However, safe levels of cholesterol can vary from person to person depending on health history and current health concerns, and are best determined by your doctor. Your doctor will use your lipid panel to make a hyperlipidemia diagnosis.
Why is physical activity important?
Physical activity is important for overall health, weight loss, and cholesterol levels. When you aren’t getting enough physical activity, your HDL cholesterol levels go down. This means there isn’t enough “good” cholesterol to carry the “bad” cholesterol away from your arteries.
How to lower cholesterol?
Eat a heart-healthy diet. Making changes to your diet can lower your “bad” cholesterol levels and increase your “good” cholesterol levels. Here are a few changes you can make: Choose healthy fats. Avoid saturated fats that are found primarily in red meat, bacon, sausage, and full-fat dairy products.
Where is cholesterol produced?
Cholesterol is produced naturally in your liver because every cell in your body uses it. Similar to triglycerides, cholesterol is also found in fatty foods like eggs, red meat, and cheese. Hyperlipidemia is more commonly known as high cholesterol.
What are the risk factors for hyperlipidemia?
Several factors are associated with an increased risk of hyperlipidemia. Modifiable risk factors include a diet high in saturated or trans fats, physical inactivity, smoking, and obesity. 1 Secondary causes of elevated LDL-C include diseases such as biliary obstruction, chronic kidney disease, type 2 diabetes mellitus, high blood pressure, and hypothyroidism. 1 Medications such as diuretics, cyclosporine, and glucocorticoids can also contribute to elevated LDL-C levels. 3 Data related to the role of race and gender in the development of hyperlipidemia have been conflicting; however, some risk factors may be more prevalent in specific races, such as obesity in non-Hispanic blacks, and thus an increased incidence of hyperlipidemia within that population. 8 Predictions of 10-year and lifetime ASCVD risk, based on patient-specific risk factors, are available in the literature. Clinical tools such as the American College of Cardiology/American Heart Association (ACC/AHA) ASCVD risk calculator, 9 can be useful in evaluating individual patient risk; however, clinicians using these resources should note that there are some limitations when using these risk predictors. The ACC/AHA has stated that the risk predictor could be used to predict stroke as well as coronary heart disease (CHD) events in non-Hispanic white and African American women and men 40 to 79 years of age. Beyond these parameters, the ASCVD risk calculator may not be a reliable predictor due to lack of sufficient data in other races or age groups. In addition, the calculator is not a reliable risk predictor for those with total cholesterol over 320 mg/dL, which would include patients with familial hypercholesterolemia (FH).
What is the name of the drug that binds to LDLRs?
Recently, a new class of medications called PCSK9 inhibitors has been approved. Alirocumab and evolocumab are monoclonal antibodies that bind to PCSK9. Normally, PCSK9 binds to LDLRs and increases their degradation, resulting in higher LDL-C levels.
What are non-statin therapies?
Several nonstatin therapies are available as adjunctive treatment for patients who do not respond adequately to statins or for those who are intolerant of statins. These include BASs, fibric acids, niacin, cholesterol absorption and synthesis inhibitors, as well as the recently approved class, PCSK9 inhibitors. 88-98
What are the limitations of statins?
Statins are the mainstay treatment for hyperlipidemia; however, the limitations of statins include treatment resistance, intolerance due to adverse events, and a lack of adherence which contribute to poor outcomes. As such, many patients require adjunct therapies to properly control hyperlipidemia including niacin, bile acid sequestrants, ...
What are the BASs?
BASs include cholestyramine, colestipol, and colesevelam. BASs reduce cholesterol by binding bile acids within the intestine, impeding bile acid reabsorption and enterohepatic cycling, increasing the conversion of cholesterol to bile acids, and increasing the number of hepatic LDLRs.
How many people have elevated LDL-C?
Epidemiology. In the United States, more than 100 million, or roughly 53% of adults, have elevated LDL-C levels. 7 Yet, fewer than 50% of patients with high LDL-C receive treatment to reduce their levels, and among those receiving treatment, fewer than 35% achieve adequate control. 1,7 Further, approximately 31 million American adults have total ...
Can statins lower LDL-C?
Limitations of Statins. While statin monotherapy can lower LDL-C levels in most patients, some patients are nonadherent, intolerant, or resistant, resulting in poor outcomes. Nonadherence to Statin Treatment.
How often should you check lipid levels after statins?
Although the ACC/AHA and NICE guidelines do not recommend treating to lipid goals, the ACC/AHA guideline recommends checking lipid levels four to 12 weeks after initiation of statins to determine a patient's adherence and every three to 12 months thereafter as clinically indicated.
How long to monitor lipid panel?
No recommendation. Follow-up lipid testing. Measure lipid panel at baseline, after four to 12 weeks to discuss adherence and lifestyle changes, and then at three- to 12-month intervals.
What is the foundation of primary prevention of ASCVD?
The foundation of primary prevention of ASCVD is therapeutic lifestyle modifications, which were reviewed in a previous issue of American Family Physician. 14 To augment the benefits of therapeutic lifestyle modification, medications developed for the treatment of lipid disorders are sometimes used for primary prevention. eTable A summarizes the contraindications, adverse effects, effectiveness, and administration considerations for these medications.
How far can you walk with statins?
A Cochrane review found that statin use among patients with peripheral arterial disease nearly doubled total walking distance, from an average of 175 to 327 m (574 to 1,073 ft); it also increased pain-free walking distances from 148 to 238 m (486 to 781 ft). 42 A 2014 meta-analysis revealed that in patients with peripheral arterial disease, statin use reduced all-cause mortality (NNT = 12; 95% CI, 9 to 23). 43
What are the risks of statins?
Major risks from statin use include myopathy (incidence of 0.5 per 1,000 more than in the general population over five years) and rhabdomyolysis (incidence of 0.1 per 1,000 more than in the general population over five years). 11 There is also a small increase in the risk of diabetes mellitus.
How long after statins should liver transaminase be checked?
Liver transaminase levels should be checked before starting statins; guidelines vary on if and when to recheck them in the absence of symptoms. Lipid levels should be rechecked one to three months after starting statins, although guidelines differ on subsequent checks.
Does statin therapy reduce the risk of cardiovascular events?
In patients with chronic kidney disease who do not require dialysis, statin therapy reduces the risk of major cardiovascular events (NNT = 16 to 25), all-cause mortality (NNT = 36 to 124), and cardiovascular mortality (NNT = 56 to 116). 48 However, statin use may not reduce all-cause or cardiovascular mortality in patients on dialysis. 49
What are the lipids in the diet?
Dietary lipids provide 30% to 40% of calories in Western diets . With the exception of the essential fatty acids (e.g., linoleic, linolenic), most lipids can also be synthesized by humans. Triglycerides, specifically, account for more than 95% of dietary lipid intake. Cholesterol from animal sources and small amounts of plant sterols comprise the majority of dietary lipid intake. Free fatty acids, phospholipids, and fat-soluble vitamins account for the remaining lipids from dietary sources [46, 50, 53].
What is polygenic hypercholesterolemia?
Polygenic hypercholesterolemia is a typical example of the combination of multiple genetic deficiencies that result in decreased activity of the LDL receptor and reduction of LDL clearance. This underlying genetic susceptibility, not yet completely understood, becomes apparent with dietary intake of saturated fats, obesity, and sedentary lifestyle. Twenty percent of polygenic hypercholesterolemia patients have a family history of CHD. Patients present with mild-to-high increases in total cholesterol (250–350 mg/dL or 6.5–9.0 mmol/L) and LDL (130–250 mg/dL or 3.33–6.45 mmol/L). A combination of lifestyle changes (e.g., reduction in saturated fat) and lipid-lowering drugs (e.g., statins, bile acid sequestrants, ezetimibe, niacin) effectively control the condition [31, 107].
What is the average cholesterol level for 20 year olds?
Data published in the National Health and Nutrition Examination Survey revealed that an estimated 12.1% of Americans 20 years of age and older have total blood cholesterol concentrations of 240 mg/dL (6.2 mmol/L) or greater, which are associated with high risk of cardiovascular morbidity and mortality [15].
What is the lowest protein in cholestrol?
Chylomicrons are large lipoproteins 75–1,200 nm in diameter that are very rich in lipids (98% content), mainly triglycerides (83%) and cholesterol (8%), and have the lowest protein content (2%) of all lipoproteins . Chylomicrons are only synthesized in the intestine and are produced in large amounts during fat ingestion [53]. In normolipidemic individuals they are present in the plasma for 3 to 6 hours after fat ingestion and are absent after 10 to 12 hours fasting [14].
What is the role of lipoprotein in atherogenesis?
The role of lipoprotein (a) in atherogenesis relates to a variety of mechanisms including inhibition of fibrinolysis by preventing the transformation of plasminogen to plasmin, enhanced capacity to traverse the arterial endothelium, and low affinity for the LDL-receptor mediated clearance from circulation [47].
Does HDL inhibit atherosclerosis?
In vitro and in vivo studies have revealed that HDL has anti-inflammatory and antioxidant properties and inhibits atherogenesis. It has been suggested that high levels of HDL have a protective effect on the development of atherosclerosis and ASCVD [88, 92].
Does statins inhibit cholesterol?
Inhibition of HMG-CoA reductase, for example by the administration of statins, not only results in direct inhibition of the intracellular synthesis of cholesterol but indirectly increases the expression of LDL receptors and therefore promotes the LDL-receptor-mediated removal of circulating cholesterol.
