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Drugs That Affect Lipid Metabolism

See Table 47-6.

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After the initiation of medical therapy, the response should be checked within the first 3 months, along with transaminase and creatinine kinase levels. Thereafter, clinical judgment should dictate the interval between follow-up visits. Although frequent visits are probably not useful for the detection of serious side effects, they serve to encourage compliance and adherence to diet and lifestyle changes.

Bile Acid–Binding Resins

Bile acid–binding resins interrupt the enterohepatic circulation of bile acids by inhibiting their reabsorption in the intestine; more than 90% of bile acids usually undergo reabsorption. Currently, their main use is as adjunctive therapy for patients with severe hypercholesterolemia caused by increased LDL-C levels. Because bile acid–binding resins are not absorbed systemically—they remain in the intestine and are eliminated in the stool—they are considered safe in children. Cholestyramine (Questran) is used in …