<prompt> Which of the following acts by inhibiting HMG CoA reductase?EzetimibeGemfibrozilClofibrateLovastatin  <response>: Ans. d Lovastatin. Ref. Harrison, Principle of Medicine, 17thTable 350-6; KDT Pharmacology, 4th ed., 618 Lipid-lowering agents Drug Major Indications Mechanism Common Side Effects HMG-CoA reductase inhibitors statins Lovastatin,Pravastatin. Simvastatin, Fluvastatin Atorvastatin, Rosuvastatin Elevated LDL-C Cholesterol synthesis, hepatic LDL receptors, vLDL production Myalgias, arthralgias, elevated transaminases, dyspepsia Cholesterol absorption inhibitors Ezetimibe Elevated LDL-C Intestinal cholesterol absorption Elevated transaminases Bile acid sequestrants Cholestyramine, Colestipol Colesevelam Elevated LDL-C Bile acid excretion LDL receptors Bloating, constipation Elevated TG Nicotinic acid Immediate-release Sustained-release Extended-release Elevated LDL-C, low HDL-C, VLDL hepatic synthesis Cutaneous flushing, GI upset, elevated glucose, uric acid, and liver function tests Fibric acid derivatives Gemfibrozil Fenofibrate Elevated TG elevated remnants LPL, VLDL synthesis Dyspepsia myalgia, gallstones elevated transaminases Omega 3 fatty acids Elevated TG TG catabolism Dyspepsia, diarrhea, fishy odor to breath 