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Supervisor : Prof. Dr.Hekma Coordinator : Ph.Fatmah Bakhder

Umm Al- Qura University Faculty of pharmacology department . Supervisor : Prof. Dr.Hekma Coordinator : Ph.Fatmah Bakhder. HYPER LIPIDEMIA. INEGY. OBJECTIVES. Trade and generic names Mechanism of action Clinical use Side effects Drug interactions Life style. INEGY.

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Supervisor : Prof. Dr.Hekma Coordinator : Ph.Fatmah Bakhder

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  1. Umm Al-Qura University Faculty of pharmacology department Supervisor : Prof. Dr.Hekma Coordinator : Ph.FatmahBakhder

  2. HYPER LIPIDEMIA

  3. INEGY

  4. OBJECTIVES • Trade and generic names • Mechanism of action • Clinical use • Side effects • Drug interactions • Life style

  5. INEGY • Therapeutic class : • Lipid-Lowering Agents • Pharmacological class : • HMG-CoA Reductase Inhibitors

  6. Trade name : • Inegy • generic name: • Simvastatin & Ezetimibe

  7. Uses of Inegy: • The main effects that produce from this drug are: • lower levels of total cholesterol, (LDL cholesterol) and triglycerides in the blood. • Raises levels of (HDL cholesterol). • Hypercholesterolaemia

  8. So. It can use if patient has: • Homozygous Familial Hypercholesterolaemia (HoFH) • patients not appropriately controlled with a statin alone • patients treated with a statin and ezetimibe

  9. M.O.A

  10. Side effect Headache. Fatigue Constipation Abdominal pain Indigestion Diarrhea Nausea ,vomiting. Hot flushes. Myopathy and Rhabdomyolysis. Myoglobinuria and acute renal failure . Photosensitivity, purpura, and alopecia.

  11. Drug - drug interaction Mainly for Simvastatin Warfarin Aspirin Niacin Fibrate Erythromycin Verapamil

  12. Drug interaction classification

  13. Simvastatin ↔ Warfarin • It acts by affecting hepatic/intestinal enzyme CYP3A4 metabolism that lead to: • Reversible Rhabdomyolysis . • Acute renal failure

  14. Simvastatin&ezetimibe • ↔cholestyramine • cholestyramine decreases levels of ezetimibe and simvastatin by inhibition of GI absorption. 

  15. Simvastatin ↔ Niacin • Either increases toxcity of the other by pharmacodynamicsynergism that increase risk of : • (Rhabdomyolysis ) for Both

  16. simvastatin ↔ fibrate • E.g. Gemfibrozil. • Either increases effects of the other by pharmacodynamic synergism lead to : • Liver damaged . • Severe myopathy and Rhabdomyolysis • renal failure secondary to Myoglobinuria and may result in death. • increased risk of musculoskeletal toxicity.

  17. simvastatin ↔ verapamilSimvastatin ↔ erythromycin • Verapamil • erythromycin • hypertension •  angina pectoris •  cardiac arrhythmia • Anti-biotic • infections

  18. simvastatin ↔ verapamilSimvastatin ↔ erythromycin • They will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism that lead to : • myopathy and Rhabdomyolysis • renal failure secondary to Myoglobinuria and may result in death. • increased risk of musculoskeletal toxicity.

  19. simvastatin level • Bosentan • (pulmonary artery hypertension) • Carbamazepine • (seizure disorders and neuropathic pain.) • Efavirenz • (human immunodeficiency virus (HIV) infection. ) • Rifampicin • (tuberculosis )

  20. LIFE STYLE

  21. DONE BY Afraa 3esa Anan fatani AnmahKinsarah GhofranRawas Lamiaaalsalmy LujainAndargiri MaramKafyah Nazmeyahalkyyal Razanbasalman Waadalhajjaje

  22. REFERENCE Textbooks: AnandRamachandran, Pharmacology recall , 2nd edition, 2007. Medical Website : SharePractice. Featured Dx: Hyperlipidemia. 04/02/2014. http://sharepractice.com/blog/featured-dx-hyperlipidemia/ (Accessed 30 Mar 2014). University of Maryland medical center. 06/04/2012. Familial combined Hyperlipidemia. May 31, 2013. http://umm.edu/Health/Medical/Ency/Articles/Familial-combined-hyperlipidemia (Accessed 30 Mar 2014).

  23. SIU School of Medicine. Hyperlipidemia. http://www.siumed.edu/surgery/vascular/hyperlipidemia.html (Accessed 30 Mar 2014). Medscape. When Do Triglycerides Matter? 2014.http://www.medscape.org/viewarticle/457696_7(Accessed 30 Mar 2014). AnupamaKizhakkeveettil, Parla S. Jayagopal and Kevin Rose. June 30, 2011. Hypercholesterolemia and Ayurvedic Medicine: A Case Report. http://www.tihcij.com/Articles/Hypercholesterolemia-and-Ayurvedic-Medicine-A-Case-Report.aspx?id=0000282 (Accessed 30 Mar 2014).

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