Drug-induced hyperlipidemia

### 날짜 : 2024-03-21 16:01 ### 주제 : Drug-induced hyperlipidemia #medicine #공부 ---- Drug-induced hyperlipidemia refers to an elevation in plasma lipids, including cholesterol and triglycerides, as a side effect of certain medications. This condition can contribute to the development of atherosclerosis and increase the risk of cardiovascular diseases, such as coronary artery disease, stroke, and peripheral arterial disease. Understanding which medications can lead to hyperlipidemia and monitoring lipid levels in patients taking these drugs are essential steps in managing this risk. ### Common Drugs Associated with Hyperlipidemia: 1. **Corticosteroids**: Long-term use of corticosteroids can increase LDL cholesterol and triglycerides while decreasing HDL cholesterol. 2. **Beta-Blockers**: Non-selective beta-blockers, especially those without intrinsic sympathomimetic activity, can worsen lipid profiles by increasing triglycerides and lowering HDL cholesterol. 3. **Diuretics**: Thiazide diuretics and loop diuretics can increase cholesterol and triglyceride levels, particularly with high doses or long-term use. 4. **Antiretroviral Therapy (ART)**: Certain protease inhibitors and other antiretroviral drugs used to treat HIV infection can lead to increased LDL cholesterol and triglycerides. 5. **Immunosuppressants**: Drugs like cyclosporine and tacrolimus, used in organ transplantation, can increase cholesterol and triglyceride levels. 6. **Atypical Antipsychotics**: Medications such as clozapine and olanzapine are associated with increased triglycerides and overall cholesterol levels. 7. **Isotretinoin**: Used for severe acne, isotretinoin can increase triglycerides and cholesterol levels. 8. **Hormonal Therapies**: Some forms of hormonal therapy, including certain oral contraceptives and hormone replacement therapy, can affect lipid metabolism, leading to elevated lipid levels. ### Pathophysiology: The mechanisms by which these drugs induce hyperlipidemia vary: - **Altered Lipid Metabolism**: Some drugs interfere with lipid metabolism pathways, affecting the synthesis, breakdown, or elimination of lipids. - **Hormonal Changes**: Drugs that affect hormonal balance can indirectly influence lipid metabolism, leading to increased production or decreased breakdown of lipids. - **Weight Gain**: Medications that lead to weight gain can indirectly increase lipid levels by altering metabolic processes. ### Management: 1. **Monitoring**: Regular monitoring of lipid profiles in patients starting on or already taking these medications. 2. **Lifestyle Modifications**: Diet and exercise are key components in managing drug-induced hyperlipidemia. A diet low in saturated fats and rich in fruits, vegetables, and whole grains is recommended. 3. **Medication Adjustments**: Depending on the severity of lipid changes and the underlying condition being treated, it may be possible to switch to alternative medications with a lower risk of affecting lipid levels. 4. **Lipid-Lowering Medications**: In some cases, the introduction of lipid-lowering agents such as statins, fibrates, or omega-3 fatty acids may be necessary. Prevention and management of drug-induced hyperlipidemia involve a comprehensive approach, including patient education, regular monitoring of lipid levels, and adjustments in therapy as needed to mitigate cardiovascular risk.