Chapter 2 BNF (Hyperlipidaemia) Flashcards
What patients should be offered primary prevention of CVD?
Type 1 Diabetes Type 2 (with 10 year CVD risk above 10%) Chronic kidney disease or albuminuria Familial hypercholesterolaemia 85 years or above
What patients should be offered secondary prevention of CVD?
Coronary Heart Disease (Angina MI) Cerebrovascular disease (Stroke/ TIA)
Peripheral Arterial Disease
What is QRISK2?
Assesses risk in 84 years and below
gives 10 year CVD risk score
Which patients are unsuitable for QRISK2 because risk will be undermined?
Type 1 diabetes established heart disease over 85 chronic kidney disease (eGFR below 60) Familial hypercholesterolaemia
What are the targets for cholesterol?
Total choleresterol <5mmol/L in healthy adults
Total cholesterol in high risk <4mmol
LDL in healthy <3mmol/L
LDL in high risk <2mmol/L
HDL >1mmol/L
Trigylcerides <1.7mmol/L
Which drugs cause hyperlipidaemia?
Antipsychotics
Immunosuppressants
Steroids
Antiretrovirals
What conditions cause hyperlipidaemia?
HypOthyroidism
liver and kidney disease
diabetes
family history
Atorvastatin doses?
20mg for primary prevention
80mg for secondary
Which statins are high intensity?
Atorvastatin 20mg and above
Rosuvastatin 10mg and above
Simvastatin 80mg (myopathy MHRA)
Whats the treatment for primary and familial hypercholesterolaemia?
High intensity statin
if contraindicated/not tolerated
Ezetimibe
Whats the treatment for moderate hypertrigylceridaemia?
Statin
not tolerated
Fibrate
Statins side effects?
Myopathy, Myositis, Rhabdomyolysis
Lung Disease
raise HbA1c levels
Statins monitoring
Baseline lipid profile
renal function
thyroid function
hbA1c if at risk of diabetes
discontinue if creatinine if 5x baseline
discontinue if liver transaminases 5x baseline
Which drugs increase statin level and increase myopathy risk?
Amiodarone Grapefruit CCB Imidazole triazole ciclosporin
How long after fusidic acid should statins be restarted?
7 days
