~Teachingcenter的醫學筆記~

降血脂用藥
Hypolipidemic agents (= antihyperlipidemic agents = lipid-lowering drugs)

Statin類(HMG CoA reductase inhibitors)對降血脂的效果

LDL = low-density lipoprotein、HDL = high-density lipoprotein
TG = triglycerols

各類降血脂藥的效果

LDL = low-density lipoprotein、HDL = high-density lipoprotein

治療藥物建議

• Single-drug therapy with marine omega-3 dietary supplement should be evaluated before drug combinations are used.

Primary chylomicronemia (familial lipoprotein lipase or cofactor deficiency: others)
-Manifestations: chylomicrons, VLDL increased
-Diet + Single drug: dietary management (omega-3 fatty acids, niacin, or fibrate)
-Drug combination: niacin + fibrate

Familial hypertriglyceridemia (severe)
-Manifestations: VLDL, chylomicrons increased
-Diet + Single drug: omega-3 fatty acids, niacin or fibrate
-Drug combination: niacin + fibrate

Familial hypertriglyceridemia (moderate)
-Manifestations: VLDL increased, chylomicrons may be increased
-Diet + Single drug: omega-3 fatty acids, niacin or fibrate
-Drug combination: niacin + fibrate

Familial combined hyperlipoproteinemia (VLDL)
-Manifestations: VLDL predominantly increased
-Diet + Single drug: omega-3 fatty acids, niacin, fibrate, or reductase inhibitor
-Drug combination: two or three of the individual drugs

Familial combined hyperlipoproteinemia (LDL)
-Manifestations: LDL predominantly increased
-Diet + Single drug: niacin, reductase inhibitor, or ezetimibe
-Drug combination: two or three of the individual drugs

Familial combined hyperlipoproteinemia (VLDL+LDL)
-Manifestations: VLDL and LDL increased
-Diet + Single drug: omega-3 fatty acids, niacin, fibrate, or reductase inhibitor
-Drug combination: niacin or fibrate + reductase inhibitor

Familial dysbetalipoproteinemia
-Manifestations: VLDL remnants, chylomicron remnants increased
-Diet + Single drug: omega-3 fatty acids, fibrate or niacin
-Drug combination: fibrate plus niacin, or either + reductase inhibitor

Familial hypercholesterolemia (heterozygous)
-Manifestations: LDL increased
-Diet + Single drug: reductase inhibitor, resin, niacin, or ezetimibe
-Drug combination: two or three of the individual drugs

Familial hypercholesterolemia (homozygous)
-Manifestations: LDL increased
-Diet + Single drug: niacin, atorvastatin, rosuvastatin, or ezetimibe
-Drug combination: niacin + reductase inhibitor + ezetimibe

Familial ligand-defective apo B
-Manifestations: LDL increased
-Diet + Single drug: niacin, reductase inhibitor, or ezetimibe
-Drug combination: niacin + reductase inhibitor or ezetimibe

Lipoprotein (a) (Lp(a)) hyperlipoproteinemia
-Manifestations: Lp(a) increased
-Diet + Single drug: niacin
-Drug combination: -