Statins and fibrates are two classes of lipid-regulating drugs. The statins competitively inhibit 3-hydroxy-3-methylglutaryl coenzyme A, HMG-CoA, reductase, an enzyme involved in cholesterol synthesis, especially in the liver. While fibrates, fibric acid derivatives, are a class of amphipathic carboxylic acids. Clinical trials reveal that statins reduce cardiovascular event rate and all-cause mortality in a broad range of demographic and risk populations. Furthermore, six statins are available in the United States; cerivastatin, a type of statin, was withdrawn from the market due to excess rates of morbidity. Moreover, statins include various drugs that differ in low-density lipoprotein, LDL, lowering efficacy and metabolic rates, thus they differ in their potential for drug and disease interactions. These drugs include atorvastatin, fluvastatin, pravastatin sodium, rosuvastatin, and simvastatin. On the other hand, fibrates, such as benzafibrate, ciprofibrate, fenofibrate, and gemfibrozil, are used for patients who cannot tolerate statin (Joint Formulary Committee, 2012). Additionally, a study indicates that patients with one of two single-nucleotide polymorphisms, SNPs, a small genetic variation, in the HMG-CoA reductase gene were less responsive to statins (mayo clinic staff, 2013). Statins and fibrates can be further compared and contrasted according to their clinical uses, precautions, side effects, contraindications, and interactions. The clinical uses of both statins and fibrates are mostly similar. Both classes lower the LDL concentration; however, Statins lower it more than the fibrates. Also, they increase the HDL, high-density lipoprotein, and decrease the triglyceride concentration, which is more in fibrates than in statins. On the other hand, statins reduce coronary events and mortality in patients with ischemic heart disease (Venes, 2009).
Increasingly, scientists are focusing on a common set of underlying metabolic issues that raise people's risk for chronic disease.
A 46-year-old Hispanic man presented to the clinic for a routine physical and a review of his recent laboratory studies. His medical history was significant for high cholesterol. His daily medication regimen included a multivitamin, aspirin 81 mg, and simvastatin (Zocor) 40 mg for high cholesterol. His family history was remarkable for type 2 diabetes, hypertension, and hyperlipidemia in his mother, maternal grandmother, maternal aunt, and maternal uncle. Physical examination revealed a height of 69 inches, weight of 199 pounds, body mass index (BMI) of 29.4 kg/m2, waist circumference of 36 inches and blood pressure of 125/72 mm Hg. Initial laboratory results were: total cholesterol 195 mg/dL; triglycerides 136 mg/dL; low-density lipoprotein cholesterol (LDL), 124 mg/dL; high-density lipoprotein cholesterol (HDL), 44 mg/dL; and fasting plasma glucose (FPG), 119 mg/dL. Complete blood count, renal function and liver function tests were all normal. Additional studies included an oral glucose tolerance test (OGTT) of 157 mg/dL and hemoglobin A1c (HbA1c) of 5.9%. The patient’s physical exam was unremarkable with no abnormalities noted.
A successful business relies strongly on strategic planning and development. Businesses strategies define a company’s future through vision and mission statements, marketing, operations, and financial performance. The purpose of this paper is to analyze and evaluate the business strategy of a public traded company, Salix Pharmaceuticals, Inc. Throughout this paper, the writer will provide a company overview, a SWOT analysis, and explore the strategic objectives and contingency plans of Salix Pharmaceuticals, Inc.
Schmitt C, Kuhn B, Zhang X, Kivitz A, Grange S. Disease--drug--drug interaction involving tocilizumab and simvastatin in patients with rheumatoid arthritis. Clinical Pharmacology & Therapeutics. 2011; 89 (5): 735--740.
A major physiological process that the human body implements to control blood pressure is through the renin-angiotensin-aldosterone regulatory pathway. The kidneys, which are a major location for water retention regulation (and through changes in blood volume regulate blood pressure), notice decreases in blood pressure and release renin, an enzyme that alters the conformation of proteins, which converts angiotensinogen into angiotensin I. Next, angiotensin I is altered into the conformation of angiotensin II by the action of angiotensin converting enzyme. Angiotensin II then causes many physiological effects that in turn increase blood pressure. These include causing cardiac hypertrophy, vasoconstriction throughout the body, stimulation of the adrenal cortex to release aldosterone and stimulation of the pituitary to release anti-diuretic hormone, each of which cause the retention of sodium and water in the kidneys. In an attempt to help regulate the blood pressure of those with hypertension, drugs have been designed that focus on the angiotensin converting enzyme. By decreasing the action of this enzyme from converting angiotensin I into angiotensin II, the physiological response to increase blood pressure that angiotensin II ensues can be greatly decreased. Through a decrease in salt and fluid retention and systemic vasodilation, blood pressure can be effectively decreased.
Hypercholesterolemia is the presence of high levels of cholesterol in the blood. Cholesterol is a waxy fat-like substance and is a major class of lipid, so it gets into the blood by lipoproteins [1]. A high level of lipoproteins is unhealthy. A high level can result in an elevated risk of atherosclerosis and coronary heart disease [2]. The high levels of lipoproteins are often influenced by a combination of genetic and environmental factors such as obesity or dieting habits [2]. High cholesterol can be caused by mutations in the following genes: APOB, LDLR, LDLRAP1, and PCSK9 [3]. Mutations in the LDLR gene are responsible for causing familial hypercholesterolemia, which is the most commonly seen form of inherited high cholesterol [3]. The LDLR gene contains instructions for making LDL receptors or low-density lipoprotein receptors. LDL receptors play critical roles in regulating levels of cholesterol in the blood by removing low-density lipoproteins from the bloodstream. Mutations in the LDLR gene can make the amount of LDL receptors produced less than normal or affect their job of removing the low-density lipoproteins in the blood [4]. People who have these mutations will have higher levels of cholesterol. There are many ways that the environment can affect the levels of cholesterol in the blood. Reducing the amount of dietary fat you consume lowers the total amount of cholesterol in the blood [5]. Sucrose and fructose can raise the amount of LDL in the blood. Reducing fatty foods will however lower the amount of LDL [5]. Having a healthy body and maintaining physical exercise plays a key role in keeping your cholesterol at a healthy level. If you are overweight or obese you can lower your cholesterol levels by simply losing ...
...6 and Sitagliptin at week 52 (p <0.001). Canagliflozin 100 mg and 300 mg reduced body weight vs placebo (week 26: –3.7%, –4.2%, –1.2%, respectively; p <0.001) and sitagliptin (week 52: –3.8%, –4.2%, –1.3%, respectively; p <0.001). Both canagliflozin doses reduced FPG and systolic BP vs placebo (week 26) and sitagliptin (week 52) (p <0.001).5
Have you ever heard of a disorder, condition or disease for the first time wondering to yourself what it is? That was me 11 years ago when my baby girl was first diagnosed with Alpha-1 Antitrypsin Deficiency, at the young age of only four months old. My heart dropped when they told me the diagnosis even though I had no idea what it was, what is meant, or how it would change our lives. I had so many questions and even to this day, the questions still seem endless. I have spent countless hours researching and asking questions trying to fully understand what it all means. As I continue to hope and pray for a cure so my daughter can live a normal long healthy life. Although there is currently no cure for Alpha-1, recent discoveries in Stem Cell research offer hope that there could be one in the future.
CAD is a leading cause of morbidity and mortality throughout the worldwide. The prevalence of biological and metabolic risk factors were also found to be high in development of coronary artery disease. Patients with hypercholesterolemia are at increased risk to experience cardiovascular events and to die from vascular disease [2]. .Statins, among the most commonly prescribed drugs worldwide, are cholesterol let downing agents used to manage cardiovascular and coronary heart diseases and to treat hypercholesterolemia. Statin’s therapy ...
The study of cardio physiology was broken up into five distinct parts all centering on the cardiovascular system. The first lab was utilization of the electrocardiogram (ECG). This studied the electrical activities of the heart by placing electrodes on different parts of the skin. This results in a graph on calibrated paper of these activities. These graphs are useful in the diagnosis of heart disease and heart abnormalities. Alongside natural heart abnormalities are those induced by chemical substances. The electrocardiogram is useful in showing how these chemicals adjust the electrical impulses that it induces.
Metabolic Syndrome (syndrome X, insulin resistance syndrome) is the name for a group of risk factors that raise your risk for diabetes mellitus (DM), cardiovascular disease (CVD), and other health problems, such as diabetes and stroke.2 It is characterized by abdominal obesity, insulin resistance, hypertension, low HDL, and elevated triglycerides. Some hallmarks of metabolic syndromes are dyslipidemia, central adiposity, and a predisposition to atherosclerotic cardiovascular disease, certain cancers, hypertension, and type 2 diabetes mellitus. Genetics appears to play an important role in predisposing certain individuals and populations to the development of metabolic syndrome.1 Multiple environmental factors modify this genetic predisposition and include physical inactivity, advancing age, cigarette smoking, and endocrine dysfunction. The presence of one or either of these signs should alert the clinician to search for other biochemical abnormalities that may be associated with the metabolic syndrome.
Berenson, A. (2005, October 21). Pfizer profit falls 5%. The New York Times, p. C7.
Depner CM, Traber MG, Bobe G, Kensicki E, Bohren KM, et al. (2013) A Metabolomic Analysis of Omega-3 Fatty Acid-Mediated Attenuation of Western Diet-Induced Nonalcoholic Steatohepatitis in LDLR-/- Mice. PLoS ONE 8(12): e83756. http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0083756
When one or several lipids combine with proteins this forms lipoproteins, these transport fat throughout the bloodstream. High-density lipoproteins, also known as HDL, carry fat away from body cells, therefore preventing its growth in the artery walls. Low-Density Lipoproteins, also known as LDL, contain a high amount of cholesterol and seem to help the build up of fatty materials in the artery walls. The situation that you should go for would be high HDL and low LDL levels. Your goal should be to keep your overall cholesterol at below 200, with LDL lower than 40, and your HDL should be at around 160. This will lower the risk of heart disease and other related problems with cholesterol.
Lazo M, Hernaez R, Bonekamp S, et al. Non-alcoholic fatty liver disease and mortality among US adults: prospective cohort study. BMJ 2011;343:d6891. http://www.bmj.com/content/343/bmj.d6891