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
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 Empedu
Cholestyramine, colesevelam, colestipol
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 Sterol
Ezetimibe
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 meningkat

Kontraindikasi
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