Antihyperlipemics

Question 0

LDL desirable range

Answer 0

Low density lipoprotein
Less than 100mg/dL

100-130= low risk
130-158= moderate risk
>160= high rosk

Question 1

HDL desirable range

Answer 1

High density lipoprotein
45- 60mg/dL

50-60= low risk
35-50= moderate risk
<35= high risk

Question 2

Therapeutic lifestyle changes to control cholesterol

Answer 2

Monitors blood lipid level
Diet
Exercise
Smoking cessation

Question 3

Bike acid sequestration mechanism of action

Answer 3

Bind bile acid in the intestinal lumen making the bike excreted in the feces and not recirculated to the liver.
Helps with the excretion of the bile

Question 4

Bile acid sequestration meds (3)

Answer 4

Cholestyramine (questran)
Colestipol (Colestid)
Colesevelam (welchol)

The “chol”

Question 5

Bile acid sequestrants effect

Answer 5

Constipation
Peptic ulcer
Bloatin
Flatulence

Question 6

bile acid sequestrants Decrease the effect of which drugs?

Answer 6

Decrease absorption of

• digoxin
• glipizide
• propranolol
• tetracycline
• thiazides
• warfarin
• Dilantin
• Thyroid meds

Question 7

When to give Bile acid sequestration ?

Answer 7

1 hours before or 4 hours after fat soluble vitamins, digoxin, glypizide, propanol, tetracycline, thiazides, coumadine, thyroids meds.

Question 8

Bile acid sequestrants contraindications

Answer 8

Peptic ulcer disease

Hemoroids, ibd, biliary obstruction

Question 9

Hydromethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors mode of action

Answer 9

Block enzyme that is required for hepatic synthesis of cholesterol
–> decrease cholesterol (in about 2 weeks), LDL, and increase HDL slightly.

Question 10

Hydromethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors meds

Answer 10

The “statins”

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• Lovastatin (Mevacor)
• Pravastatin sodium (Pravachol)
• Simvastatin (zocor)

Question 11

(HMG-CoA) reductase inhibitors side effects and adverse effects

Answer 11

Side effects:
Nausea, constipation, diarrhea
Adverse effects:
Hepatotoxicity, Myopathy, Cataract formation and rhabdomyolysis

Question 12

Nursing consideration with the (HMG-CoA) reductase inhibitors “statin”

Answer 12

• Patient should inform of muscle pain/weakness –>rhabdomyolysis
• Patient should get eye exam Qyear –> cataract formation
• monitor liver enzyme labs Ast/Alt
• stopping the Tx abruptly may cause a threefold rebound effect and can lead to an AMI.
• teach pt that tx is lifetime

Question 13

Advantage/ disadvantage of bile acid sequestran

Answer 13

Helps with secretion of bile acid and lower blood lipid but also binds to fat soluble vitamin and may elevate triglycerides therefore should not be given for only triglyceride levels.
can cause adek vit deficiency

Question 14

What is the action of Niacin

Answer 14

Increase HDL and Decrease LDL, VLDL.

Exact mechanism is unknow

Question 15

Disadvantage of Nicotinic acid (niacin, niaspan)

Answer 15

Require a large dose for Max effectiveness which is associated with lots of side effects (flushing, pruritus, paresthesia, HA, Hepatotoxicity, gout, hyperglycemia)–> poor compliance

Question 16

What can help with Nicotinic acid side effects (niacin, niaspan)

Answer 16

Administration of ASA 30 min prior to give meds can help.

Question 17

What are nursing consideration

With Nicotinic acids? (niacin, niaspan)

Answer 17

Monitor AST/ALT and caution pt with DM of hyperglycemia