Anti-Hyperlypidemics Flashcards
VLDL
Very Low Density Lipoprotein
1. Primary carrier of triglycerides in the blood
HMG-CoA Reductase Inhibitor
-Examples
“STATINS”
- Lovastatin
- Atorvastatin
- Simvastatin
HMG-CoA Reductase Inhibitor (Statins)
-Action
- Lowers cholesterol, LDL, VLDL
- Increases HDL
- Helps prevent atherosclerosis which leads to CAD, AMI, Vascular disease
HMG-CoA Reductase Inhibitor (Statins)
-Contraindications
- Elevated liver enzymes
2. Liver disease Pt’s
HMG-CoA Reductase Inhibitor (Statins)
-Interactions
- Cyclosporine
- Gemfibrozil (Lopid)
- Erythromycin
CAN INCREASE RISK OF MYOPATHY OR RHABDOMYOLYSIS
HMG-CoA Reductase Inhibitor (Statins)
-Adverse Effects
- Hepatitis (Inflammation of the liver)
- Myopathy & Rhabdomyolysis
- Weakness
HMG-CoA Reductase Inhibitor (Statins)
-Implications
- 4-6 weeks for therapeutic response (FACTORY)
- Report muscle weakness or pain
- Report COLA COLOR urine changes
- Liver function studies
- Avoid sunlight or wear sunscreen
Bile Acid Sequestrant
- Examples
- Cholestyramine (Questran)
2. Colestipol (Colestid)
Bile Acid Sequestrant
-Action
- Binds bile in the INTESTINE, causing the complex to be EXCRETED out. (DELIVERY SYSTEM)
- Decreases LDL and cholesterol levels
- Increases clearance rate of cholesterol but DOES NOT prevent hepatic synthesis of cholesterol
Bile Acid Sequestrant
-Contraindications
- Complete biliary obstruction
Bile Acid Sequestrant
-Adverse Effects
- Increased PT – Anemia
- GI – flatulence, N/V
- CONSTIPATION (most common)
- Decrease fat soluble vitamin absorption
Bile Acid Sequestrant
-Implications
- Works faster than HMG-CoA reductase because it works on delivery.
- Take at mealtimes, w/ fluids (dry powder)
- Teach ways to prevent, or lessen, constipation
- increase fluids & bulk in your diet.
Fibric Acid Derivative
-Example
- Gemfibrozil (Lopid)
Fibric Acid Derivative (Lopid)
-Action
- Unclear of action - Reduces VLDL
- Inhibits cholesterol formation early
- Excretion of cholesterol is increased
- Decreases triglycerides, cholesterol, LDL, VLDL
- LOPID can increase HDL
Fibric Acid Derivative (Lopid)
-Contraindications
- Renal or hepatic dysfunction
- Cholelithiasis
- Pregnancy
Fibric Acid Derivative (Lopid)
-Drug Interaction
- Oral anticoagulants (increased)
- Lovastatin and gefibrozil together increases risk of rhabdomyolysis and myopathy
- Sulfonylureas (hypoglycemia)
Fibric Acid Derivative (Lopid)
-Adverse Effects
- GI - N/V/D pain
- Renal or liver dysfunction
- WBC alterations
- Muscle soreness and weakness
Fibric Acid Derivative (Lopid)
-Implications
- Take before meals
- 1 to 2 months for therapeutic response
- Blood work before and during treatment
- REPORT BLEEDING
Niacin
-Action
- Inhibits lipolysis of adipose tissue
- Decreases triglycerides, cholesterol, LDL, VLDL
- Increases HDL
Niacin
-Contraindications
- Hepatic dysfunction
- Severe hypotension
- Gall bladder disease, peptic ulcers
- Diabetes
Niacin
-Interactions
- Antihypertensives
2. HMG-CoA reductase inhibitors
Niacin
-Adverse Effects
- Flushing, warmth, headache – MOST COMMON
- GI flatulence, n/v peptic ulcers
- Rare dysrhythmias
Niacin
-Implications
- Take w/ cold fluids, and foods
- Baseline liver, CBC labs
- Watch for liver dysfunction
- Sustained release might reduce flushing
- Report muscle pain or weakness
- Report any visual changes
Drugs for Lipid Disorders
-Assessment
- Obtain blood samples
- Assess labs – triglycerides, total cholesterol, LDL, HDL
- Clients height and weight
- Nursing hx: lifestyle, current drugs, dietary habits
Drugs for Lipid Disorders
-Nursing Diagnoses
- Knowledge deficit regarding condition
- Ineffective regimen mgmt
- Risk for bleeding
