Hypolipidemic agent

Kelompok 4
Fakultas Kedokteran
Universitas Nusa Cendana
2015

Hypolipidemic Agent
Pengertian

Obat yang digunakan untuk menurunkan

kadar lipid plasma. Tindakan
menurunkan kadar lipid plasma
merupakan salah satu tindakan yang
ditujukan untuk menurunkan resiko
penyulit aterosklerosis

Atorvastatin, Simvastatin, Rosuvastatin, Pitavastatin

Overview
Sekuestran asam
empedu

Inhibitor Penyerap
Sterol

Statin

(HMG-CoA reductase inhibitor)

Atorvastatin, Simvastatin, Rosuvastatin, Pitavastatin

LDL Reduction : 25-60%

Menghambat biosintesis kolestrol

(Kompetitif inhibitor HMG-CoA reduktase)
Pembentukan Kolesterol
Reseptor lipoprotein LDL dan VLDL di hepatosit
trigliserida (sedikit)

Atorvastin

(Regular tablet)

*Initial
: 10-20 mg PO /hari
*Maintenance: 10-80 mg PO /hari

Indikasi
Hiperlipidemia
Pencegahan penyakit kardiovaskular(10-80
mg /hari)

Kontraindikasi

Hipersensitifitas pada atorvastin,Penyakit liver

aktif, Kehamilan dan laktasi
Toksisitas : miopati dan disfungsi hati

Fibrat

Gemfibrozil, fenofibrate

LDL Reduction : 15%

Agonis peroxisome proliferator activated receptor-Alpha

Lipoprotein lipase
katabolisme VLDL
Fatty acid oxidation
Triglycerides elimination
hepatic axtration of fatty acid
HDL

Gemfibrozil
*600mg PO q12hr
*administration : 30 min before morning and
evening meal
Indikasi : Hipertrigliseridemia dan HDL rendah

Kontraindikasi
Penyakit hepatik, Penyakit ginjal, penyakit
gallblader, primary biliary cirrhosis
Toksisitas : Miopati dan disfungsi hati

Sekuestran Asam
Cholestyramine, colesevelam, colestipol
Empedu
LDL Reduction : 15%

Ikat asam empedu

Katabolime kolesterol
Reseptor LDL
LDL

Cholestyramine
* 4g PO q12-24hr
*not to exceed 24g/day (4g q4hr)
*indikasi : LDL Meningkat, Toksisitas digitalis,
Pruritus

Kontraindikasi

Hipersensitifitas, Complete biliary obstruction,

serum trigleserida >500mg/dL, history of
hypertrigliseridemia induced pancreatitis
Toksisitas : konstipasi, perut kembung,
mengganggu penyerapan sebagian obat dan
vitamin

Inhibitor Penyerap
Ezetimibe
Sterol
LDL Reduction : 15%

Inhibit sterol transpoter

Absorbsi kolestrol intestinal oleh
asam empedu
LDL dan Fitosterol

Ezetimibe
*10 mg PO qDay
*administration : 30 min before morning and
evening meal
*Indikasi : LDL meningkat dan Fitosterolemia

Kontraindikasi
Bersama statin pada penderita penyakit
hepatik, hipersensitifitas
Toksisitas : Insiden rendah hepatotoksisitas &
miositis

Vitamin B3
Niacin

LDL Reduction : 10%

Menghambat sintesis VLDL (dan

sekresinya di hati)
HDL LDL dan trigliserida
Niacin
*Immediate release : 250mg PO q6-8h/Day
Dose adjusted every 4-7 days
Do not exceed 6g/day
*Extended release
: 500mg/day PO at bed
time
Dose adjusted every 4 weeks
Do not exceed 1-2g/day
*indikasi : HDL rendah, VLDL dan LDL
Kontraindikasi
meningkat
Hipersensitifitas,Penyakit hepatik,active pentic
ulcer, severe hypotension, arterial bleeding

Combination Drug
Lovastatin and niacin
Atorvastatin and amlodipine
Simvastatin and niacin
Atorvastatin and ezetimibe
Simvastatin and ezetimibe

Refference based on :

1. American Heart Association. Drug Therapy

for Cholesterol. December 10, 2012.
Accessed May 14, 2014
2. Miller M, Stone NJ, Ballantyne C, Bittner V,
Criqui MH, Ginsberg HN, et al. Tryglicerides
and cardiovaskular diseaseL a scientific
statement from the American Heart
Association. Circulation. May 24
2011:123(20): 2292-333[Medline]
3. Stone NJ, Robinson J, Lichtenstein AH,
Bairey Merz CN, Lloyd-Jones DM, Blum CB,
et al. Treatment of Blood Cholestrol to
reduce Atherosclerotic Cardiovaskular risk
in adults : A Report of the American
College of Cardiology/American Heart
Association Task Force on Practice
Guidelines. J Am Coll Cardiol. Nov 7
2013 [Medline]
4. Farmakologi dasar dan klinik (Bertram G.
Katzung) edisi 12, 2014
5. Farmakologi dan terapi (FKUI) edisi 5,
2007