41. Hyperlipidemia Medications Flashcards
Causes of primary hyperlipidemia
genetic or familial
Causes of secondary hyperlipidemia
More common
- dietary habits
- DM
- alcoholism
- hypothyroidism
- obesity
- obstructive liver disease
4 types of lipoproteins
HDL, LDL, VLDL, and chylomicrons
3 types of lipids that form lipoproteins
- cholesterol
- phospholipids
- triglycerides
most common lipids (90%); 3 fatty acids attached to a glycerol backbone; major storage of fat in the body and only type of lipid that serves as an important energy source
triglycerides
type of lipid that forms when a phosphate group replaces a fatty acid in a triglyceride; essential to building plasma membranes; best known are lecithins (egg yolks and soybeans)
phospholipids
cholesterol is most widely known; vital component of plasma membranes and building block of essential biochemicals; synthesized by liver and diet from animal products (don’t need diet); only need minute amount (< 300mg/day)
steroids
What is contained in every lipoprotein?
cholesterol, phospholipid, and triglyceride bound to a protein
Desired range of lipids
- total cholesterol: 150-200
- triglycerides: 40-150
- LDL: <100
- HDL: >60
nonpharmacologic methods to reduce cholesterol
- low-fat diet
- Mediterranean diet or DASH diet
- increased intake of fiber
- exercise
- smoking cessation
general characteristics of antidyslipidemics
- decrease blood lipids
- prevent/delay atherosclerosis
- promote regression of existing plaques
- reduce morbidity and mortality from CAD
MOA of statins (Rosuvastatin)
inhibition of enzyme HMC-CoA reductase in cholesterol biosynthesis -> decreases LDL and slightly increases HDL
What happens if statins are withdrawn
- cholesterol and LDL levels return to pretreatment levels (usually lifetime commitment)
- abrupt withdrawal can lead to 3x rebound effect that may cause death from MI
uses for Rosuvastatin
- decrease LDL, hypercholesterolemia and hyperlipoproteinemia and atherosclerosis
- CAD risk reduction in DM
Side effect/adverse effects of Rosuvastatin
- rhabdomyolysis
- elevated liver enzymes
- myopathy
- hepatotoxicity
When is Rosuvastatin contraindicated
- acute hepatic disease
- pregnancy (category X)
Pt teaching for Rosuvastatin
- may take several weeks for lipid levels to decrease
- need for liver enzymes to be monitored
- take in evening w/ meal
- avoid grapefruit/grapefruit juice -> toxic levels
What should patients do before a lipid panel is done?
fast for 12 hours
What class of meds is Cholestyramine
Bile Acid Sequestrant
MOA of Cholestyramine
forms a resin that limits the reabsorption of bile acids in the intestines which causes bile acids to be excreted in feces
Uses of Cholestyramine
- lower LDL
- itching caused by liver disease
- diarrhea
Adverse effects of Cholestyramine
- GI effects such as ABD fullness
- flatulence
- constipation
- osteoporosis
- Vitamin A, D, and K deficiency
How is Cholestyramine administered?
power (mixed w/ food or liquids)
nursing implications for Cholestyramine
- avoid taking other meds w/ it (blocks absorption)
- wait 4-6 hours after administration to take any other meds
