Question:easy
Which drug binds bile acids in the intestine and prevents their return to the liver via the enterohepatic circulation?
Which drug binds bile acids in the intestine and prevents their return to the liver via the enterohepatic circulation?
Show Hint
Think of the non-absorbable resin that traps bile salts in the gut.
Updated On: Jun 24, 2026
- Niacin
- Fenofibrate
- Cholestyramine
- Gugulipid
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: Bile acids made in the liver are normally secreted into the gut, reabsorbed from the ileum, and recycled back to the liver. This recycling loop is the enterohepatic circulation.
Step 2: To block the loop you need a substance that traps bile acids before they can be reabsorbed. Cholestyramine is a positively charged resin that is not absorbed itself; it grabs the anionic bile acids and carries them out in the stool.
Step 3: With less bile acid coming back, the liver must use up stored cholesterol to manufacture replacement bile acids. The resulting rise in hepatic LDL receptor activity clears circulating LDL, which is the therapeutic goal.
Step 4: Comparing the choices, only the resin works inside the intestinal lumen. Niacin, fenofibrate, and gugulipid all act on systemic lipid metabolism rather than physically binding bile salts. Hence the bile acid sequestrant is the right pick.
\[\boxed{\text{Cholestyramine}}\]
Step 2: To block the loop you need a substance that traps bile acids before they can be reabsorbed. Cholestyramine is a positively charged resin that is not absorbed itself; it grabs the anionic bile acids and carries them out in the stool.
Step 3: With less bile acid coming back, the liver must use up stored cholesterol to manufacture replacement bile acids. The resulting rise in hepatic LDL receptor activity clears circulating LDL, which is the therapeutic goal.
Step 4: Comparing the choices, only the resin works inside the intestinal lumen. Niacin, fenofibrate, and gugulipid all act on systemic lipid metabolism rather than physically binding bile salts. Hence the bile acid sequestrant is the right pick.
\[\boxed{\text{Cholestyramine}}\]
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