Antihyperlipidemics

Question 0

Very low density lipids

Answer 0

•Primary carrier of triglycerides in blood

Question 1

Low density lipids

Answer 1

•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

Question 2

High density lipids

Answer 2

•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

Question 3

Nonpharmacological means of decreasing cholesterol

Answer 3

●Diet

●Exercise

Question 4

2 main ways antihyperlipidemics work

Answer 4

• Either decrease the factory’s packaging system

* Prevent the packaged goods to be absorbed

Question 5

HMG-CoA Reductase Inhibitor

Answer 5

• Blocks the production of cholesterol
• Lowers cholesterol, LDL, VLDL
• Increases HDL
• Helps to prevent atherosclerosis which leads to CAD, AMI, Vascular disease

Question 6

HMG-CoA Reductase Inhibitor medications

Answer 6

•Lovastatin, atorvastatin, simvastatin

Question 7

HMG-CoA Reductase inhibitor contraindications

Answer 7

• Elevated liver function labs

* Liver disease patients

Question 8

HMG-CoA Reductase inhibitor adverse reactions

Answer 8

• Hepatitis, pancreatitis
• GI effects: alterations in taste, change in appetite
• Fever, malaise, muscle pain or weakness
• Myopathy and rhabdomyolysis

Question 9

HMG-CoA Reductase inhibitor teaching

Answer 9

• 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

Question 10

Bile acid sequestrant

Answer 10

• 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

Question 11

Bile acid sequestrant medications

Answer 11

•Cholestyramine (Questran)

colestipol (Colestid)

Question 12

Bile acid sequestrant contraindications

Answer 12

•Complete biliary obstruction

Question 13

Bile acid sequestrant adverse effects

Answer 13

• 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

Question 14

Bile acid sequestrant pt. teaching

Answer 14

• Works faster than HMG-CoA reductase inhibitors
• Take at mealtimes, with fluids (dry powder)
• Teach ways to prevent, or lessen, constipation

Question 15

Fibric acid derivative

Answer 15

• Unclear of action, reduces VLDL
• Inhibits cholesterol formation early, excretion is increased
• Decreases triglycerides, cholesterol, LDL, VLDL

Question 16

Fibric acid derivative meds

Answer 16

•Gemfibrozil (Lopid)

Can increase HDL

Question 17

Fibric acid derivative contraindications

Answer 17

• Renal or hepatic dysfunction
• Cholelithiasis
• pregnancy

Question 18

Fibric acid derivative adverse effects

Answer 18

• GI N/V/D pain
• Muscle soreness and weakness
• WBC alterations
• Renal or liver dysfunction

Question 19

Fibric acid derivative implications

Answer 19

• Take before meals
• Therapeutic response in 1 to 2 months
• Blood work before and during treatment
• Report any bleeding

Question 20

Niacin

Answer 20

• Inhibits lipolysis of adipose tissue
• Decreases triglycerides, cholesterol, LDL, VLDL
• Increases HDL

Question 21

Niacin contraindications

Answer 21

• Hepatic dysfunction
• Severe hypotension
• Gall bladder disease, peptic ulcers
• Diabetes mellitus

Question 22

Niacin adverse effects

Answer 22

• Flushing, warmth, headache most common!
• GI flatulence, n/v peptic ulcers
• Rare dysrhythmias

Question 23

Niacin teaching and implications

Answer 23

• 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

Question 24

Total cholesterol values

Answer 24

Desirable 239

Question 25

LDL cholesterol values

Answer 25

160- 190 high risk to very high risk

Question 26

HDL cholesterol values

Answer 26

60 desirable

Question 27

Triglycerides

Answer 27

<200-500 high risk to very high risk