Medicine & USMLE

Fish Oil and Omega-3s

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Cardiovascular Pharm (Old)
  1. Adenosine
  2. Magnesium
  3. Nitroprusside
  4. Nitrates
  5. Ivabradine
  6. Digoxin/Digitalis
  7. Class IA Antiarrhythmics
  8. Class IB Antiarrhythmics
  9. Class IC Antiarrhythmics
  10. Class II Antiarrhythmics
  11. Class III Antiarrhythmics - Amiodarone
  12. Class III Antiarrythmics - Sotalol
  13. Class III Antiarrhythmics - Ibutilide, Dofetilide
  14. Class IV Antiarrhythmics - Verapamil, Diltiazem
  15. HMG-CoA Reductase Inhibitors (Statins)
  16. Ezetimibe
  17. Fibrates
  18. PCSK9 Inhibitors (Alirocumab, Evolocumab)
  19. Fish Oil and Omega-3s
  20. Milrinone
  21. Aliskiren
  22. Hydralazine
  23. Ranolazine
  24. Sacubitril

Summary

Fish oil contains omega-3 fatty acids, which lower VLDL and triglyceride levels. Clinically, they are therefore used to treat hypertriglyceridemia. Side effects may include nausea and a fish taste.

Key Points

  • Fish Oil / Omega-3s
    • Fish oil contains omega-3 fatty acids
      • Docosahexaenoic acid (DHA)
      • Eicosapentaenoic acid (EPA)
    • Clinical Use
      • Treats hypertriglyceridemia
    • Mechanism
      • ↓ VLDL production / ↓ triglycerides
        • The mechanism is really multifactorial--everything from inflammation to PPAR has been implicated
        • VLDL carries endogenous triglycerides, so VLDL and triglycerides are highly related
      • ↓ Apo B synthesis
        • Apo B-100 is the core structural protein for VLDL, so decreased apo B should obviously decrease VLDL. That being said, the mechanism is again multifactorial, so there’s not a single slam-dunk mechanism as to why fish oil works
    • Adverse Effects
      • Nausea
      • Fishy taste