GEM - lipid lowering treatment educational module part one
Lipid Lowering Educational Module
Scenario 1:
- 46 year old man with a history of type 2 diabetes. Glycaemic control revealed an HBA1c of 7.2%. Lipid profile revealed a total cholesterol of 6.5 mmol/l, LDL of 3.4 mmol/l, HDL 1.1 mmol/l and fasting triglycerides of 3.4 mmol/l
- should a cardiovascular risk equation be used in this situation? GPnotebook reference...click here
- if lipid lowering treatment was to be used, then what base-line investigations would be considered before starting statin therapy? GPnotebook reference...click here
- this gentleman had his lipids monitored four weeks after initiating a statin. Is this period of time too soon? GPnotebook reference...click here
- which two important trials are concerned with the use of statins in patients with diabetes?
Scenario 2:
- 55 year old lady with a history of manic depression. She is on treatment with olanzapine and it has been noted that her weight has increased since initiation of her olanzapine treatment. Recent blood tests revealed a fasting glucose of 6.2 mmol/l. Her fasting lipids revealed a cholesterol of 7.7 mmol per litre and triglycerides of 4.4 mmol/l. Other secondary causes of hyperlipidaemia were excluded.
- what is significant about her fasting glucose level? GPnotebook reference...click here
- is olanzapine associated with possible development of diabetes? GPnotebook reference...click here
- how might olanzapine affect this lady's lipid levels?GPnotebook reference...click here
- this lady was put on simvastatin 40mg per day and her cholesterol was 5.4 mmol/l. What reference is useful in deciding what the next step in statin treatment might be? GPnotebook reference...click here
Examples of other causes of raised lipids:
- how does abnormal thyroid funtion affect lipid levels? GPnotebook reference...click here
- how does HRT affect lipid levels? GPnotebook reference...click here
Myalgia and statin treatment
- how common is myalgia associated with statin treatment? GPnotebook reference...click here
Statins and warfarin
- does pravastatin interact with warfarin? GPnotebook reference..click here
NICE
- what does NICE say about the use of statins in prevention of cardiovascular disease? GPnotebook reference..click here
Drugs used in hypertriglyceridaemia include:
- fibrates GPnotebook reference...click here
- fish oils GPnotebook reference...click here
What conditions are associated with a low HDL? GPnotebook reference...click here
Other lipid lowering agents include:
- ezetimibe, a cholesterol absorption inhibitor GPnotebook reference...click here
- bile sequestrants GPnotebook reference...click here
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