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Resumen de faramacologia en dismlipidemia con nombre de marcacos, mecanismo de acción, dosis, presentación, Ram y usos
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Farmacología de las dislipidemias (hipolipemiantes)Las lipoproteínas movilizan la grasa, esta tiene una característica apolar, hidrofóbico, no es compatible con la
circulación.
No hay medicamento que aumente las
concentraciones de HDL, por lo que solo se
puede disminuir las NO-HDL.
ApoB100 es un marcador de riesgo. ApoA1 es
un marcador protector.
- Perfil lipídico mínimo dan colesterol total, triglicéridos y HDL.
- RVC <100 mg/dl
- Si tiene riesgo alto debe tener LDL <70 mg/dl
Tamizaje y diagnóstico
- Perfil lipídico en ayunas (>30 años): TGL – C total – HDL
- Se realiza el cálculo manual de LDL (fórmula de Friedewald) si TGL > 400 mg/dl. Si están elevados esa
fórmula no funciona.
cLDL = colesterol total – cHDL – (triglicéridos /5)
Después de tener la valoración, se puede hacer una aproximación a un diagnóstico.
Clasificación práctica
- Hipercolesterolemia pura
- Hipertrigliceridemia pura
- Dislipidemia mixta
Riesgo bajo o leve: <10
Riesgo medio: 10-19
Riesgo alto: >20
FARMACOTERAPIA
Tratamiento Descenso LDL (%) Incremento HDL (%) Disminución TG (%)
Estatinas (1º) 25-55 4-12 14-29
Ezetimibe 18-25 1 9
Resinas 10-18 3 Neutro o ↑
Ac. Nicotínico 10-20 14-35 30-70
Fibratos (2º) 4-21 11-13 30
Estatinas se pueden unir a las ezetimibes
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