Antihyperlipidemics Flashcards
Very low density lipids
•Primary carrier of triglycerides in blood
Low density lipids
•LDL transports cholesterol from liver to tissues and organs
●Used to build plasma membranes and synthesize other steroids
•Carries highest amount of cholesterol
•Known as bad cholesterol
●Contributes to plaque deposits and coronary artery disease
High density lipids
•Manufactured in liver and small intestine
•Reverse cholesterol transport
●Assists in transport of cholesterol away from body tissues and back to liver
•Known as good cholesterol
●Transports cholesterol for destruction and removal from body
Nonpharmacological means of decreasing cholesterol
●Diet
●Exercise
2 main ways antihyperlipidemics work
- Either decrease the factory’s packaging system
* Prevent the packaged goods to be absorbed
HMG-CoA Reductase Inhibitor
- Blocks the production of cholesterol
- Lowers cholesterol, LDL, VLDL
- Increases HDL
- Helps to prevent atherosclerosis which leads to CAD, AMI, Vascular disease
HMG-CoA Reductase Inhibitor medications
•Lovastatin, atorvastatin, simvastatin
HMG-CoA Reductase inhibitor contraindications
- Elevated liver function labs
* Liver disease patients
HMG-CoA Reductase inhibitor adverse reactions
- Hepatitis, pancreatitis
- GI effects: alterations in taste, change in appetite
- Fever, malaise, muscle pain or weakness
- Myopathy and rhabdomyolysis
HMG-CoA Reductase inhibitor teaching
- Take in evening time
- Allow 4 to 6 weeks for therapeutic response
- Give 2 hours after a bile acid sequestrant
- Avoid sunlight or wear sunscreen
- Report muscle weakness or pain
- Report urine color changes
- Liver function studies
Bile acid sequestrant
- Binds bile in the intestine, causing the complex to be excreted out
- Decreases LDL and cholesterol levels
- Increases clearance rate of cholesterol but does not prevent hepatic synthesis of cholesterol
Bile acid sequestrant medications
•Cholestyramine (Questran)
colestipol (Colestid)
Bile acid sequestrant contraindications
•Complete biliary obstruction
Bile acid sequestrant adverse effects
- Constipation (most common)
- Headache, fatigue
- Anemia
- Increased prothrombin time
- Muscle and joint pain
- Weight change
- GI include flatulence, n/v/ pain,
- Can decrease fat soluble vitamin absorption
Bile acid sequestrant pt. teaching
- Works faster than HMG-CoA reductase inhibitors
- Take at mealtimes, with fluids (dry powder)
- Teach ways to prevent, or lessen, constipation
Fibric acid derivative
- Unclear of action, reduces VLDL
- Inhibits cholesterol formation early, excretion is increased
- Decreases triglycerides, cholesterol, LDL, VLDL
Fibric acid derivative meds
•Gemfibrozil (Lopid)
Can increase HDL
Fibric acid derivative contraindications
- Renal or hepatic dysfunction
- Cholelithiasis
- pregnancy
Fibric acid derivative adverse effects
- GI N/V/D pain
- Muscle soreness and weakness
- WBC alterations
- Renal or liver dysfunction
Fibric acid derivative implications
- Take before meals
- Therapeutic response in 1 to 2 months
- Blood work before and during treatment
- Report any bleeding
Niacin
- Inhibits lipolysis of adipose tissue
- Decreases triglycerides, cholesterol, LDL, VLDL
- Increases HDL
Niacin contraindications
- Hepatic dysfunction
- Severe hypotension
- Gall bladder disease, peptic ulcers
- Diabetes mellitus
Niacin adverse effects
- Flushing, warmth, headache most common!
- GI flatulence, n/v peptic ulcers
- Rare dysrhythmias
Niacin teaching and implications
- Take with 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
