Pharmacology · patient case question
What is the mechanism of action of his lipid-lowering medication?
Patient case: Medical history review before treatment
Patient: 60-year-old patient completing a medical history update.
Chief complaint: Routine care.
History: Reports a diagnosis of peptic ulcer disease treated some years ago, and current treatment with atorvastatin for hyperlipidemia.
Findings: No acute dental findings. History review only.
Show answer and explanation
Correct answer: A. Inhibition of HMG-CoA reductase
- A. CORRECT. Statins competitively inhibit HMG-CoA REDUCTASE, the rate-limiting enzyme of the mevalonate pathway. Reduced hepatic cholesterol synthesis upregulates LDL receptors and clears LDL from the circulation. Dental relevance: statins are CYP3A4 substrates, so azole antifungals and macrolides raise statin levels and myopathy risk.
- B. Bile acid sequestration describes cholestyramine and colesevelam.
- C. Fibrates increase lipoprotein lipase activity via PPAR-alpha, targeting triglycerides rather than LDL.
- D. Blocking intestinal absorption at the NPC1L1 transporter is the mechanism of ezetimibe.