WordNet
- (botany) either of the two parts of a bilabiate corolla or calyx
- either the outer margin or the inner margin of the aperture of a gastropods shell
- either of two fleshy folds of tissue that surround the mouth and play a role in speaking
- the act of causing something to move to a lower level (同)letting down
- the act of causing to become less
- use recreational drugs (同)do drugs
- administer a drug to; "They drugged the kidnapped tourist" (同)dose
- a substance that is used as a medicine or narcotic
- an oily organic compound insoluble in water but soluble in organic solvents; essential structural component of living cells (along with proteins and carbohydrates) (同)lipide, lipoid
PrepTutorEJDIC
- 〈C〉『くちびる』,口もと / 《複数形で》(発音器官としての)くちびる,口 / 〈U〉《俗》生意気な言葉 / 〈C〉(容器などの)口,へり,縁;(峡谷・火山などの)口 / 〈C〉(植物の)唇弁(しんべん)
- 低くする,低下させる;堕落させる
- (空模様が)険悪な,荒れ模様の / しかめっつらの,(顔つきが)不機嫌な
- 『薬』,薬品,薬剤 / 『麻薬』,麻酔剤 / 〈人〉‘に'薬(特に麻酔剤)を与える / 〈飲食物〉‘に'(麻酔薬・毒薬などの)薬を混ぜる
- 脂質,あぶら
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/31 01:29:16」(JST)
[Wiki en表示]
Hypolipidemic agents, or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of hyperlipidemias. They are called lipid-lowering drugs.
Contents
- 1 Classes of hypolipidemic drugs
- 1.1 Established
- 1.2 Investigational
- 2 References
- 3 See also
Classes of hypolipidemic drugs
There are several classes of hypolipidemic drugs. They may differ in both their impact on the cholesterol profile and adverse effects. For example, some may lower the "bad cholesterol" low density lipoprotein (LDL) more so than others, while others may preferentially increase high density lipoprotein (HDL), "the good cholesterol". Clinically, the choice of an agent will depend on the patient's cholesterol profile, cardiovascular risk, and the liver and kidney functions of the patient, evaluated against the balancing of risks and benefits of the medications. In the United States, this is guided by the evidence-based guideline from the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATPIII).
Established
- Statins are particularly well-suited for lowering LDL, the cholesterol with the strongest links to vascular diseases. In studies using standard doses, statins have been found to lower LDL-C by 18% to 55%, depending on the specific statin being used. There is a risk of severe muscle damage (myopathy & rhabdomyolysis) with statins. Hypercholesterolemia is not a risk factor for mortality in persons older than 70 years and risks from statin drugs are more increased after age 85.[1]
- Fibrates are indicated for hypertriglyceridemia. Fibrates typically lower triglycerides by 20% to 50%. Level of the good cholesterol HDL is also increased. Fibrates may decrease LDL, though generally to a lesser degree than statins. Similar to statins, there is a risk of severe muscle damage (myopathy & rhabdomyolysis).
- niacin, like fibrates, is also well-suited for lowering triglycerides by 20–50%. It may also lower LDL by 5–25% and increase HDL by 15–35%. Niacin may cause hyperglycemia, and may also cause liver damage. The niacin derivative acipimox is also associated with a modest decrease in LDL.
- Bile acid sequestrants (resins, e.g. cholestyramine) are particularly effective for lowering LDL-C by sequestering the cholesterol-containing bile acids released into the intestine and preventing their reabsorption from the intestine. It decreases LDL by 15–30% and raises HDL by 3–5%, with little effect on triglycerides but can cause a slight increase. Bile acid sequestrants may cause gastrointestinal problems, and may also reduce the absorption of other drugs and vitamins from the gut.
- ezetimibe (Zetia) is a selective inhibitor of dietary cholesterol absorption.
- lomitapide (Juxtapid) is a microsomal triglyceride transfer protein (MTP) inhibitor.
- phytosterols may be found naturally in plants. Similar to ezetimibe, phytosterols reduce the absorption of cholesterol in the gut. Hence, they are most effective when consumed with meals. However, the precise mechanism of action of phytosterols differs from ezetimibe.
- orlistat (Xenical): Its primary function is to prevent the absorption of about 30% of fats from the human diet; thereby reducing caloric intake (a drug designed to treat obesity) is by inhibiting Pancreatic lipase- an enzyme that breaks down triglycerides in the intestine.
Investigational
Investigational classes of hypolipidemic agents:
- CETP inhibitors (cholesteryl ester transfer protein), 2 candidates are in trials. It is expected that these drugs will mainly increase HDL while lowering LDL;
- Squalene synthase inhibitor;
- ApoA-1 Milano
- succinobucol(AGI-1067), a novel antioxidant, failed aphase 3 trial
- Apoprotein-B inhibitor Mipomersen (approved by the FDA in 2013 homozygous familial hypercholesterolemia.[2][3]).
- PCSK9 Monoclonal antibody inhibitors [4][5]
References
- ^ AMDA – The Society for Post-Acute and Long-Term Care Medicine (February 2014), "Ten Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation (AMDA – The Society for Post-Acute and Long-Term Care Medicine), retrieved 20 April 2015 .
- ^ Pollack, Andrew (29 January 2013) F.D.A. Approves Genetic Drug to Treat Rare Disease The New York Times, Retrieved 31 January 2013
- ^ Staff (29 January 2013) FDA approves new orphan drug Kynamro to treat inherited cholesterol disorder U.S. Food and Drug Administration, Retrieved 31 January 2013
- ^ Koren MJ, Scott R, Kim JB et al Lancet 2012; 380:1995-2006
- ^ Gugliano RP, Desai NR, Kohli P et al Lancet 2012; 380:2007-17
See also
|
Lipid modifying agents (C10)
|
|
| GI tract |
| Cholesterol absorption inhibitors, NPC1L1 |
|
|
| Bile acid sequestrants/resins (LDL) |
- Cholestyramine
- Colestipol
- Colestilan
- Colextran
- Colesevelam
|
|
|
| Liver |
| Statins (HMG-CoA reductase, LDL) |
- Simvastatin#
- Atorvastatin
- Fluvastatin
- Lovastatin
- Mevastatin
- Pitavastatin
- Pravastatin
- Rosuvastatin
- Cerivastatin‡
|
|
| Niacin and derivatives (HDL and LDL) |
- Niceritrol
- Niacin
- Nicofuranose
- Aluminium nicotinate
- Nicotinyl alcohol
- Acipimox
|
|
| MTTP inhibitors (VLDL) |
- Dirlotapide
- Lomitapide
- Mitratapide
|
|
|
| Blood vessels |
| Fibrates (PPAR) |
- Clofibrate‡
- Bezafibrate
- Aluminium clofibrate
- Gemfibrozil
- Fenofibrate
- Simfibrate
- Ronifibrate
- Ciprofibrate
- Etofibrate
- Clofibride
- Clinofibrate
|
|
| CETP inhibitors (HDL) |
- Anacetrapib†
- Dalcetrapib§
- Evacetrapib†
- Torcetrapib§
|
|
|
| Combinations |
- Niacin/lovastatin
- Niacin/simvastatin
- Ezetimibe/simvastatin
- Ezetimibe/atorvastatin
- Niacin/laropiprant
|
|
| Other |
- Dextrothyroxine‡
- Probucol
- Tiadenol
- Benfluorex
- Meglutol
- Omega-3-triglycerides
- Magnesium pyridoxal 5-phosphate glutamate
- Policosanol
- Lapaquistat§
- Mipomersen
- Alipogene tiparvovec
|
|
- #WHO-EM
- ‡Withdrawn from market
- Clinical trials:
- †Phase III
- §Never to phase III
|
|
|
Index of nutrition
|
|
| Description |
- Vitamins
- Cofactors
- Metal metabolism
- Fats
- metabolism
- intermediates
- lipoproteins
- Sugars
- Glycolysis
- Glycogenesis and glycogenolysis
- Fructose and galactose
|
|
| Disease |
- Vitamins
- Carbohydrate
- Lipid
- Metals
- Other
- Symptoms and signs
- Tests
|
|
| Treatment |
- Drugs
- Vitamins
- Mineral supplements
|
|
|
UpToDate Contents
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English Journal
- Statins and the brain: New perspective for old drugs.
- Ling Q1, Tejada-Simon MV2.
- Progress in neuro-psychopharmacology & biological psychiatry.Prog Neuropsychopharmacol Biol Psychiatry.2016 Apr 3;66:80-6. doi: 10.1016/j.pnpbp.2015.11.013. Epub 2015 Dec 2.
- Statins are one of the most popular lipid-lowering drugs (LLDs). Upon oral administration, these drugs are well absorbed by the intestine and effectively used for the treatment of dyslipidemias. Recently, statins are becoming also well-known for their cholesterol-independent effects and their potent
- PMID 26655447
- Changes in lipoprotein lipase and endothelial lipase mass in familial hypercholesterolemia during three-drug lipid-lowering combination therapy.
- Tada H1, Kobayashi J2, Kawashiri MA3, Miyashita K4, Nohara A5, Inazu A6, Nakajima K7, Mabuchi H5, Yamagishi M3.
- Lipids in health and disease.Lipids Health Dis.2016 Apr 2;15(1):66.
- BACKGROUND: This study was performed to compare the effects of three different lipid-lowering therapies (statins, ezetimibe, and colestimide) on lipoprotein lipase and endothelial lipase masses in pre-heparin plasma (pre-heparin LPL and EL mass, respectively) from patients with familial hypercholest
- PMID 27039080
- Alirocumab: A Review in Hypercholesterolemia.
- Greig SL1, Deeks ED2.
- American journal of cardiovascular drugs : drugs, devices, and other interventions.Am J Cardiovasc Drugs.2016 Apr;16(2):141-52. doi: 10.1007/s40256-016-0166-3.
- Alirocumab (Praluent(®)) is a monoclonal antibody against proprotein convertase subtilisin/kexin type 9 (PCSK9) that is administered via subcutaneous injection every 2 weeks. Across ten phase III studies from the ODYSSEY clinical trial program in patients with heterozygous familial hypercholestero
- PMID 26935836
Japanese Journal
- Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease
- 中島 啓
- International Journal of Hepatology 2012(Article ID 950693), 1-13, 2012
- … In the last decade, it has been shown that metformin, thiazolidinediones, vitamin E, ezetimibe, n-3 polyunsaturated fatty acids, renin-angiotensin system (RAS) blockers, and antiobesity drugs may improve hepatic pathophysiological disorders as well as clinical parameters. … Accordingly, insulin sensitizers, antioxidative agents, Niemann-Pick C1-like 1 (NPC1L1) inhibitors, RAS blockers, and drugs that target the central nervous system may represent candidate pharmacotherapies for NAFLD and possibly NASH. …
- NAID 120005352595
- "Just Make It Lower" Is an Alternative Strategy of Lipid-Lowering Therapy With Statins in Japanese Patients – LDL-Cholesterol: The Lower, the Better; Is It True for Asians? (Con) –
- Sakamoto Tomohiro,Ogawa Hisao,サカモト トモヒロ,オガワ ヒサオ,坂本 知浩,小川 久雄
- Circulation journal : official journal of the Japanese Circulation Society 74(8), 1731-1741, 2010-07-25
- … In this situation, not only strong but also standard statins are still advantageous and the so-called pleiotropic effects of the drugs come to the fore. …
- NAID 10026566182
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★リンクテーブル★
[★]
- 関
- decline、decrease、depression、drop、fall、lower、reduction
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[★]
- 同
- drugs