😍🖼Animated Mnemonics (Picmonic):
It’s medicos is perfection ellos worm medicine makes perfect sense another video about cardiac pharmacology today we have a mnemonic about niacin and lots of unfunny jokes and some words of wisdom it doesn’t matter how smart you are until you stop and think mmm preach this is very similar to another professor who said just because you have a phd doesn’t mean you can’t
Be an sob so you’re saying that getting a phd is a bad idea no kathryn i did not say that stop it and by the way sob here stands for shorts of breath because i’m a good guy i don’t curse i also got to keep this channel advertiser friendly man sometimes life can give you avvocato other times it can give your nuts maybe something bad happened in your life you fail
The test and broke up with your significant other so you decided to take revenge you went to a fast-food restaurant and order 10 cheeseburgers because even though you’re smart you don’t stop and think cheeseburgers are absolutely delicious but they contain lots of fat fat is gonna enter your mouth your gi tracts and then it’s gonna be absorbed in your gi tract it
Gets absorbed here remember my video about the lymph i have another video about anatomy of the lymph node i have a third video about the lymphatic system i have several videos about lymphoma anyways in this wall of the intestine it gets absorbed into the epithelium of your gi tract and then it gets packaged not in mortgage-backed securities not even in your stupid
Amazon packages it gets packaged in beautiful chylomicrons and then they go to the interstitial and then they go to the lymph capillaries olympic vessels and big veins specifically the portal vein because this is part of the portal venous system territory not the systemic circulation this is part of the portal not the cable now portal circulations gonna end up in
Your liver your liver will synthesize some cholesterol and now this is cholesterol in the liver do not confuse the cholesterol that’s in the liver with your dietary cholesterol that was in the double cheeseburger after your lovely liver literally plays with cholesterol it’s gonna secure the lipids into your venous circulation this is the hepatic vein part of the
Systemic cable system not to be confused with the portal system okay now it’s in my bloodstream in the bloodstream we will convert that cholesterol it’s going to reach that blood stream as freaking vldl so now i’m in the blood stream and vldl what the flip is build a very low density lipoprotein and then thanks to an enzyme called lipoprotein lipase this vldl will
Become idl and then after that it becomes ldl ldl has many choices couldn’t go back to the liver it can go to the blood stream it can go to muscles etc etc or literally to any organ or any cell in your body ldl is low density lipoprotein that’s the ugly bad cholesterol so hdl is the good cholesterol ldl is the bad cholesterol how do you remember it h is the happy
Cholesterol l is the lousy cholesterol if you don’t get rid of this ldl or if the level of ldl rise in your blood it can precipitate in the wall of your beautiful blood vessel and these are known as atherosclerosis plaques and these plaques are very dangerous because they can lead to heart attack to talk about your heart or strokes if you’re talking about the brain
And they come in different shapes and forms in the heart we have something called angina which is ischemia and myocardial infarction which is an unfortunate so here is the ischemia here is the unfortunate in your beautiful brain it’s different the ischemia is called ti a and the unfortunate the freaking stroke and then after eating bazillion cheeseburgers and french
Fries throughout your life you may develop a heart attack at the age of 49 and then you will use a defense mechanism called a rationalization and another one known as projection and say mcdonald’s is killing me shut up jeffrey you ordered 10 cheeseburgers with fries and they are a restaurant when you order 10 cheeseburgers from a restaurant they’re gonna give you
Your 10 freaking cheeseburgers duh that’s not their fault just own it jeffrey owned it i’ve done many stupid things in my life to learn from your mistakes and try to lower your risk factors pointing fingers at others is not going to lower your ldl by one iota i mean by one milligrams per deciliter by the way what is the normal ldl level in the plasma if you say
Less than 100 you are an astute and cute student so these are the drugs that could lower your lipids statins fibrates cholestyramine niacin which is a hormone synthesis lipase inhibitor is it a my pcsk9 inhibitors and been peed awake acid which was literally approved by the fda last friday stuff is happening and do not expect to hear that from your pharmacology
Professor any time soon he hasn’t opened a textbook like in five or 10 years or something he has tenure why should he and of course if he hasn’t opened a textbook recently do not expect him to be subscribing to the new york heart association website and getting up-to-date information so how did you hear about padova cassatt medico says i was reading a financial
Newspaper life is weird like who reads the wall street journal to learn about form ecology that will be me that’s who he is let me know in the comment section if you want me to make a video about pompadour acid niacin or nicotinic acid has two functions one has nothing to do with the other it could be vitamin b3 check out my playlist on biochemistry or it could
Be an anti hyperlipidemia drug this happens at a lower dose and this one happens at a higher dose it’s like aspirin at a lower dose it’s antiplatelet at a higher dose it’s anti-inflammatory how about moderate dose let me know the answer in the comment section here is how freakin nice and works back to our story about the double cheeseburger remember here is your
Stomach and then an intestine gets absorbed and then the fat ends up in your liver your liver will use an enzyme called hmg-coa and then it will produce cholesterol this is called de novo cholesterol synthesis by the way there are many raw materials that help form this cholesterol including that acetyl coenzyme a that’s why we called hmg-coa and mr. hdl the good
Cholesterol the high density lipoprotein they will form cholesterol and then cause from gonna end up in the blood stream and you know the story the ldl thanks to lipoprotein lipase becomes ideal intermediate density lipoprotein thanks to other stuff it becomes ldl the bad cholesterol the low-density lipoprotein it gets oxidized and it now it’s called oxidized ldl
This is really bad athos collects boom in your vessels what is the fate of these lipids some of them go back to the liver others precipitate to form a true socratic flex others go to be used by your fat cells and your muscle cells specifically to be stored so the fats going to my fat tissue my adipose tissue which look like a signet ring and it just stays there
And then there is a process called lipolysis let’s say i want to break down this fat to produce energy called free fatty acids the enzyme responsible for lipolysis is known as hormone sensitive lipase and it produces free fatty acid niacin does two things number one it inhibits the step what’s the name of the step it’s the conversion of cholesterol into vldl now
Cholesterol not gonna be converted into the ldl so cholesterol is gonna rise and anything upstream is gonna rise including your hdl which is great because this is the good cholesterol you want the good to go up baby niacin has another beautiful function it inhibits the hormone sensitive lipase now you will not break your fat cells into freakin free fatty acid in
The bloodstream so it inhibits lipolysis thank you so much nice and so nice and it inhibits the vldl synthesis by the liver absolutely true which will lower your ldl lower your bad cholesterol which is amazing this by the way will increase your good cholesterol which is equally amazing it also inhibits the hormone sensitive lipase and therefore inhibits lipos and
Decrease the level of the free fatty acids in the bloodstream a y is like free fatty acid bad isn’t that a source of energy it’s true they are a source of energy you know what else if you combine them with glycerol you get triglyceride which is not cool because triglycerides are part of your total cholesterol total cholesterol equals hdl good plus the ldl bad plus
Triglycerides over five also bad so triglycerides are bad ldl is bad and then hdl is good you add them together you get your total cholesterol so if you have lots of this floating around and then they combine two cholesterol and then they give you triglycerides the level of triglycerides in your plasma will go up which is bad and therefore the level of the total
Cost will go up any replies man this is also bad that’s how niacin is freaking amazing hey nice and can you please speak for yourself yeah my mechanism of action is to inhibit the vldl synthesis by the liver this will lower the ldl that’s amazing i also happen to simulate something called niacin receptor 1 or niac niacin receptor 1 or nicotinic related receptor
Who cares this is gi coupled this will lower your cyclic mp because this is what gi does when you lower your cyclic a and p will inhibit the hormone synthesis lipase this will lower your free fatty acids cool it also increases edible nicks and adiponectin happens to be anti-inflammatory when we’re talking about a thorough sclerotic disease you know that ethical
Disease is kind of an inflammatory process it’s not just some physical lips clogging your vessel that’s not exactly true it’s an inflammatory process with macrophages fibroblasts and some nasty cells also mr. niacin prevents the conversion of the hdl cholesterol into vldl down the road therefore hdl level will go up hdl is the good cholesterol that’s amazing also
Nice and inhibits the hepatic clearance of hdl therefore hdl level will go up that’s awesome what are the clinical uses of niacin to increase your hdl and to lower your ldl niacin happens to be very good indeed in increasing your hdl it’s not the best to lower the ldl statin we’ll kick its butt not to mention pcsk9 inhibitors these are very strong it’s so expensive
What are the side effects of freaking nice and a lot indeed flushing itching paresthesia pins and needles and then hyperglycemia and hyperuricemia which is bad if you have gout note to increase compliance and decrease side effects you should start with a small dose then increase the dose if you’ve done everything you should pharmacology is the queen of medicine
Yet no one knows how to cherish that queen if you’re starting to fall in love with pharmacology for the first time in your life check out my cardiac pharmacology course on my website this lecture is just a sample of what you expect how does niacin actually cause flushing that’s a long story man g-protein coupled receptor it has seven parts if you remember physiology
Or molecular biology or whatever and then it’s arachidonic acid araki lacaze it has two pathways check out my video on the ironic acid the cyclooxygenase pathway and the lipo oxygenase pathway the life oxygen age will make the life of asthma patients hell but that’s not the topic of today’s video the topic of today’s video is the cyclooxygenase it will produce their
Pg e 2 and the pg d2 what is pg prostaglandin baby these prostaglandins will dilate the smooth muscles of your blood vessel when you dilate the vessels in your face you become like this flushed flushing so you’re saying that the niacin induced flushing is prostaglandin related yes indeed that’s absolutely true so how can you prevent flushing inhibit this freakin
Cyclooxygenase is there a drug that does such a thing yes it’s called aspirin baby give aspirin 30 minutes before giving niacin the aspirin will inhibit the cyclooxygenase this will reduce the prostaglandin which will reduce flushing mission accomplished but which dose of aspirin should you give should he give the low dose which is antiplatelet or the high dose which
Is anti-inflammatory prostaglandins are inflammatory freakin mediators you give the astronauts at the be high dose because it’s anti-inflammatory and it’s going to inhibit in the cycle oxidase and reduce the inflammatory mediator so you give the aspirin 325 milligrams this is in the united states in the uk it’s a different number but it’s still a high freaking dose
All of this was just an introduction to the mnemonic the mnemonic is about side effects of niacin nice and will cause flushing itching gouge hyperuricemia hyperglycemia and paresthesia here is an insulin pump okay let me tell you more about flushing flushing of niacin happens in 80% of patients it lies between tim is even too many hours pressed a glendon related
Therefore the mast cells will secrete prostaglandins prostaglandin will dilate the smooth muscles of the blood vessel you will end up with flushing how to prevent it to give aspirin this is called prophylaxis a sprint 30 minutes before giving nice and what dose of aspirin the high dose the 325 the anti-inflammatory dose some people argue that if you give nice and
For a very long term like chronically the patient may reduce their flushing day by day one by one okay niacin and the eight mnemonic niacin will decrease 1h and increase another h the h that’s going to go down is the hormone sensitive lipase that’s the mechanism of action of the freakin niacin the other edge that’s going to go up is your beautiful good cholesterol
High density lipoprotein look at this beauty pharmacology is the beautiful queen of medicine so here is the slide that talks about lipids can you talk to me about the mechanism of action of niacin of course i can nice and has two mechanisms the first mechanism is to inhibit the formation or the synthesis of vldl now vldl is history and therefore the cholesterol is
Gonna go slightly up but then the good thing is that the hdl will also go up the next mechanism is that in inhibits lipolysis so like pulses is not gonna happen therefore you will not break down your lipids and you will not release free fatty acids in the bloodstream question of the day which anti hyperlipidemia drug lower ldl the most for instance is it stanton is
It niacin is it fibrates is it whatever comes tyramine which one lowers triglycerides the most and which one raises hdl the most let me know the answers in the comment section also this is what you get if you download my cardiac pharmacology course from my website go to medicos is perfectionist come to get this coding for my college course which contains 50 videos
Cases and questions with answers of course notes and mind maps these notes that i’m drawing for these lectures you get to download and then you can print and to enjoy yourself medicine is fine use the promo code cardio form 50 to get a 50% discount this is limited for to any students only only 20 are available if you love these pharmacology videos let me know in the
Comment section please subscribe hit the bell and click on the join button to join the tribe also smash like you can support my channel here or here send me an email here get my colleague pharmacology course here or my antibiotics course thank you so much for watching as always be safe stay happy and study hard this is medicos whisper fiction a loss where medicine makes perfect sense
Transcribed from video
Cardiac Pharmacology (3) | Niacin with a Mnemonic By Medicosis Perfectionalis
