Teleconference Summaries

AACVPR Webcast: Therapeutic Options for the Patient with Refractory Hyperlidiemia, offered at LifePointe.

Reviewed by Monica Vandergriend RN

The presenter discussed the ideal impact of exercise on Lipid levels, and then the effect of various Lipid lowering medications (Statins, Non-statins: Ezetimibe, Fibrates, Resins, Niacin and Omega III’s).

He went on to discuss what to do if, in spite of lifestyle changes and meds, the patient is unable to attain lipid treatment goals, and clinical approaches to the statin myalgias.

He identified the common lipid managment errors, such as; inadequate dose/lack of titration, lack of f/u, use of statins for TRIG elevation, d/c statins for mild ALT or Ck elevations and for patient myalgias and not re-starting of investigatin etiologies, lack of pt education on niacin (hot flashes, and how to prevent), lack of statin interaction awareness, failure to alter fibrate dose for renal insuff, use of Colesevelam for increased TRIG, and finally failure to refer to clinical Lipidologist when all else fails.

Familial Hypercholesterolemia was discussed, as well as LDL Apheresis (process of selective removal ofa apolipoprotein B-containing oparticles in drug-resistant hypercholesterolemia). This process is done at various institutions around the US, including Nebraska. (They did not tell where it is done). This is a medicare, private insurance and government payor covered procedure.

Finally he discussed a case study pulling together the information he had given us. He also offered a web site for more information: www.uhhospitals.org/ldl.

I thought it was worthwhile webcast.