Anti-Cholesterol Drugs Flashcards
list the roles of cholesterol in the body
component of all cell membranes and membranes of intracellular organelles.
required for the synthesis of certain hormones (estrogen, progesterone, testosterone)
required for synthesis of bile salts
deposited in the stratum corneum of the skin where it reduces evaporation of water and blocks transdermal absorption of water-soluble compounds.
identify the enzyme HMG-CoA reductase as the key step in cholesterol synthesis.
HMG-CoA reductase is the rate-limiting enzyme of cholesterol biosynthesis. The expression level of this membrane-bound enzyme is controlled by many factors that in turn regulate cholesterol synthesis and cellular cholesterol homeostasis.
differentiate between the total cholesterol, HDL, LDL, lipoproteins, and state the screening cutpoints.
total cholesterol is how much cholesterol someone has in their body
HDL is the good cholesterol
LDL is the bad cholesterol which is involved in atherosclerosis of the arteries
Total cholesterol: want less than 200 mg/dL
LDL (“bad”) cholesterol: want less than 100 mg/dL
HDL (“good”) cholesterol: want greater than or equal to 60 mg/dL
explain the sequence of atherosclerotic plaque formation in the coronary arteries
- endothelium of vessel is damaged
- transport of LDLs from the arterial lumen into endothelial cells that line the lumens of blood vessels.
- From there, they move into the space that underlies the arterial epithelium.
- LDL’s then become OXIDIZED.
4a. oxidized LDL’s attract monocytes and convert the monocytes to machrophages
4b. inhibit macrophage motility, trapping them at the site of atherogenesis - as macrophages eat more cholesterol, they become large and develop large vacuoles, called foam cells.
- Foam cell accumulation beneath the arterial epithelium produces a fatty streak, which makes the surface of the arterial wall lumpy, causing the blood flow to become turbulent
- Smooth muscle cells migrate to the site, synthesizing collagen, repeated rupturing and healing of the endothelium
- mature atherosclerotic lesion forms, marked by a large lipid core and a tough fibrous cap.
list the treatment goals for high cholesterol levels
treatment goals are to reduce long term risk and promote a healthy lifestyle.
list the features of a nondrug TLC diet
reduced intake of cholesterol and saturated fats, minimize intake of trans fats,
increase intake of soluble fiber (oatmeal)
and increase intake of plant sterols (found in vegetable oils and nuts, fruits, beans, and other vegetables)
list the beneficial actions, mechanism of cholesterol reduction, therapeutic uses, and the adverse effects of the Hmg-Coa inhibitors (aka the Statins).
beneficial actions
beneficial actions: reduction of LDL (bad) cholesterol, elevation of HDL (good cholesterol), reduction of triglyceride levels, promote atherosclerotic plaque stability, reduce inflammation at plaque site, slow progression of coronary artery calcification, improve abnormal endothelial function, enhance vasodilation, reduce risk of atrial fibrillation, reduce the risk of thrombosis (by inhibiting platelet deposition and aggregation and suppressing clotting factor–thrombin–formation)
list the benefical actions, mechanism of cholesterol reduction, therapeutic uses and the adverse effects of HMG-CoA inhibitors (aka the statins)
mechanism
mechanisms:
statins increase the number of LDL receptors on hepatocytes, but inhibit the enzyme HMG-CoA reductase. As a result, cholesterol synthesis is restored to pre treatment levels.
more receptors, less synthesis
list the beneficial actions, mechanism of cholesterol reduction, therapeutic uses, and adverse effects of the statins.
therapeutic uses
hypercholesterolemia
primary and secondary prevention of CV events, primary prevention in people with normal LDL levels, post MI therapy, diabetes
list the beneficial actions, mechanism of cholesterol reduction, therapeutic uses and the adverse effects of HMG-CoA inhibitors–the statins.
adverse effects
adverse effects include myopathy, hepatoxicity, new-onset diabetes, memory loss, cataracts.
list the benefits and risks of eating fish/fish oils.
Who should eat fish, who should avoid fish?
people that have HTN, high cholesterol and etc. should eat fish.
be careful with fish in pregnancy, also if you’re allegric (I don’t know what this one wants lol).
summarize the major nursing implications for patients taking anti-cholesterol drugs, particularly the statins.
statins are given to achieve the therapeutic outcome of lowering LDL cholesterol, along with lifestyle and diet changes.
They lower cholesterol by increasing the number of LDL receptors and inhibiting Hmg-CoA.
potential AE’s can include myopathy, cataracts, new-onset diabetes, memory loss, and more.
Monitor and document.
