Scene 1

Lipoproteins. Lipid Protein Lipoprotein. 

Scene 2

Scene 3

Lipoprotein =               lipid transport

Causes of Hyperlipidemia Lifestyle Diabetes Mellitus Kidney disease Pregnancy Hypothyroidism Genetic Alcohol Dyslipidemia Drugs- Thiazides, Cyclosporin, Glucocorticoids, Beta Blockers.. 

Scene 4

Causes of Hyperlipidemia
Lifestyle
Diabetes Mellitus
Kidney disease
Pregnancy
Hypothyroidism
Genetic
Alcohol
Dyslipidemia
Drugs- Thiazides, Cyclosporin,
Glucocorticoids, Beta Blockers.

Protein Phospholipid Cholesterol Triglyceride A. A lipoprotein 0000 0 Chylomicron — VI-DL HDL B. The variety Of lipoproteins Blood Lipids Serum Triglycerides • VLDL • CHYLOMICRONS Serum Cholesterol • LDL (Bad, 77.5%) • HDL (Good, 17.5%) IDL (Neutral, 5%). 

Scene 5

Protein
Phospholipid
Cholesterol
Triglyceride
A. A lipoprotein
0000 0
Chylomicron
— VI-DL
HDL
B. The variety Of lipoproteins
Blood Lipids
Serum Triglycerides
• VLDL
• CHYLOMICRONS
Serum Cholesterol
• LDL (Bad, 77.5%)
• HDL (Good, 17.5%)
IDL (Neutral, 5%)

1-chylomicron mainly T.G carry lipid from intestine to liver 2-VLDL mainly T.G from liver to blood 3-ILDL half cholesterol half T.G 4-LDL mainly cholesterol bad cholesterol 5-HDL from tissues to liver good cholesterol. 

Scene 6

1-chylomicron     mainly T.G    carry lipid from intestine to liver   2-VLDL      mainly T.G    from liver to blood 3-ILDL      half cholesterol half T.G  4-LDL      mainly cholesterol      bad cholesterol 5-HDL       from tissues to liver       good cholesterol

6/1/2022. Life Cycle of Cholesterol-carrying LIPOPROTEINS Liver produces LIPOPROTEINS LDL Lipoprotein Molecule Triglyceride (fat) VLDL fat ce Ils TRIGLYCERIDE Muscle burn TRIGLYCERIDE. 

Scene 7

Life Cycle of Cholesterol-carrying LIPOPROTEINS
Liver produces
LIPOPROTEINS
LDL
Lipoprotein Molecule
Triglyceride (fat)
VLDL
fat ce Ils
TRIGLYCERIDE
Muscle burn
TRIGLYCERIDE

Scene 8

0.95 1 .006 1 .02 1 .06 1.10 1.20 HDL o 5 o 10 IDL LDL 20 VLDL 40 Diameter, nm Chylomicron remnants Chylomicron 60 80 1 ooo. 

Scene 9

0.95
1 .006
1 .02
1 .06
1.10
1.20
HDL
o
5
o
10
IDL
LDL
20
VLDL
40
Diameter, nm
Chylomicron
remnants
Chylomicron
60
80
1 ooo

Antihyperlipedemic drugs. Hyperlipidemia SINGLE USE ONLY. 

Scene 10

Classification. Statins Niacin Fibrates Bile acid resins, Ezetimibe. 

Scene 11

Statins  Niacin   Fibrates   Bile acid resins, Ezetimibe

BILE ACID-BINDING RESINS (CHOLESTYRAMINE) 1-Bind to bile acids in the intestine decrease cholesterol and T.G absorption 2-prevent their absorption and . preventing the recycling of bile acids, bile acid-binding resins divert hepatic cholesterol to synthesis of new bile acids, thereby reducing the amount of cholesterol.. 

Scene 12

BILE ACID-BINDING RESINS (CHOLESTYRAMINE) 1-Bind to bile acids in the intestine decrease cholesterol and T.G absorption  2-prevent their absorption and . preventing the recycling of bile acids, bile acid-binding resins divert hepatic cholesterol to synthesis of new bile acids, thereby reducing the amount of cholesterol.

Mechanism of action. ÙØªÙØ¬Ø© Ø¨Ø­Ø« Ø§ÙØµÙØ± Ø¹Ù âªbile binnding resinâ¬â. 

Scene 13

Side effect 1-GIT disturbance (steatorrhea) 2-decrease absorption of fat soluble vitamins 3-cholesterol gall stones. 

Scene 14

Side effect            1-GIT disturbance (steatorrhea)                2-decrease absorption of fat soluble vitamins           3-cholesterol gall stones

Scene 15

Mechanism of action Selective inhibition of cholesterol absorption both 1-exogenous (dietary ) 2-endogenous (biliary). 

Scene 16

Mechanism of action     Selective inhibition of cholesterol absorption      both        1-exogenous (dietary )      2-endogenous (biliary)

Scene 17

Preparations (HMG CO A Reductase inhibitors) atorvastatin, simvastatin. 

Scene 18

Preparations (HMG CO A Reductase inhibitors) atorvastatin, simvastatin

Mechanism of action Inhibition of HMG-co A reductase decrease so, inhibit synthesis of cholesterol in liver. 

Scene 19

Mechanism of action  Inhibition of HMG-co A reductase decrease so, inhibit synthesis of cholesterol in liver

RedwJaL
STATINS
IDI
Jooluftfål
t•tdomc
STOP

Side effects of statins MUSCLE Muscle pain Rhabdomyolysis LIVER Liver failure. 

Scene 20

Side effects of statins
MUSCLE
Muscle pain
Rhabdomyolysis
LIVER
Liver failure

Scene 21

Mechanism of action ( agonist to nicotinic acid VIT B3 ) Inhibition of lipolysis decrease FFA production decrease T.G synthesis in liver. 

Scene 22

Mechanism of action    ( agonist to nicotinic acid VIT B3 )  Inhibition of   lipolysis decrease FFA production   decrease T.G synthesis in liver

S.E OF NIACIN 1-increase P.G vasodilators hypotension ,flushing(can be managed by NSAIDS ) 2- increase histamine release in GIT HCL secretion ,colic. 

Scene 23

S.E OF NIACIN  1-increase P.G vasodilators    hypotension ,flushing(can be managed by NSAIDS )  2- increase histamine release in GIT    HCL secretion ,colic

Scene 24

Mechanism of action of fibrates Agonist of PPAR nuclear receptor (activation of lipoprotein lipase) metabolism of T.G. 

Scene 25

Mechanism of action of fibrates  Agonist of PPAR nuclear receptor  (activation of lipoprotein lipase)       metabolism of T.G

26. 1- GIT disturbance 2-cholesterol gall stones 3-liver enzymes elevation 4-myopathy. 

Scene 26

1- GIT disturbance  2-cholesterol gall stones  3-liver enzymes elevation  4-myopathy

COMBINATION THERAPY: Drug combinations are often required to achieve the maxi- mum lowering effect with minimum toxicity Certain drug combinations provide advantages whereas others present specific challenges.. 

Scene 27

COMBINATION THERAPY:   Drug combinations are often      required to achieve the maxi- mum lowering effect  with minimum toxicity  Certain drug combinations provide advantages whereas others present specific challenges.

Because resins interfere with the absorption of certain HMG-CoA reductase inhibitors these must be given at least 1 h before or 4 h after the resins. The combination of reductase inhibitors (statin) with fibrates increases the risk of myopathy.. 

Scene 28

Because resins interfere with the absorption of certain HMG-CoA reductase inhibitors these must be given at least 1 h before or 4 h after the resins.   The combination of reductase inhibitors (statin) with fibrates increases the risk of myopathy.

1-statin,resin (time interval) 2-statin ,niacin 3-niacin,resin Good combinations 1-fibrate,resin both increase gall stones 2-statin,fibrate both hepatotoxic ,myopathy Bad combinations. 

Scene 29

1-statin,resin  (time interval) 2-statin ,niacin  3-niacin,resin   Good combinations 1-fibrate,resin  both   increase gall stones 2-statin,fibrate   both  hepatotoxic ,myopathy  Bad combinations