What do bile acid sequestrants do?

What do bile acid sequestrants do?

• A. Inhibit HMG-CoA reductase
• B. Increase cholesterol absorption
• C. Bind bile acids in the intestine, facilitating cholesterol excretion
• D. Increase bile acid production

Answer: (C)

Bile acid sequestrants work by binding bile acids in the intestine, forming insoluble complexes that are excreted in the feces. This interrupts enterohepatic circulation, reducing the bile acid pool and prompting the liver to convert more cholesterol into bile acids and to upregulate LDL receptors, which pulls more LDL cholesterol from the bloodstream. The result is lower circulating LDL cholesterol. This differs from statins, which inhibit HMG-CoA reductase, and from ideas about increasing cholesterol absorption or directly boosting bile acid production—the effect here comes from increased excretion and the liver compensating by using more cholesterol to make bile acids.

Bile acid sequestrants work by binding bile acids in the intestine, forming insoluble complexes that are excreted in the feces. This interrupts enterohepatic circulation, reducing the bile acid pool and prompting the liver to convert more cholesterol into bile acids and to upregulate LDL receptors, which pulls more LDL cholesterol from the bloodstream. The result is lower circulating LDL cholesterol. This differs from statins, which inhibit HMG-CoA reductase, and from ideas about increasing cholesterol absorption or directly boosting bile acid production—the effect here comes from increased excretion and the liver compensating by using more cholesterol to make bile acids.