Antilipemic Agents Flashcards
What is the therapeutic action of STATINs?
To decrease VLDL and LDL and increase HDL.
What pregnancy category are statins?
Category X
What are the therapeutic uses for statins?
hypercholesterolemia, prevention of coronary events, strokes, and to increase HDL levels
these are usually the first line antilipemic used
Along with having some take an antilipemic agents, what else should be taught to the patient?
Lifestyle changes!
What are some adverse effects of statins?
hepatotoxicity
myopathy - breaks down muscle tissue
peripheral neuropathy
What are some primary nursing considerations for statins?
obtain baseline liver functions and monitor liver function after 12 weeks and then every 6 months
look out for signs of liver failure (jaundice, n/v, anorexia)
obtain a baseline CK levels (byproduct of muscle breakdown)
tell the client to report any muscle aches, pain, or tenderness
Advise the client to report any numbness, tingling, or pain in the hands/feet
What are some patient teaching points for statins?
avoid pregnancy (cat X)
must use two forms of birth control and one should be a barrier method
Avoid alcohol - also causes liver dysfunction
avoid grapefruit juice - increases risk for toxicity
report signs of myopathy, liver failure, peripheral neuropathy
keep lab appointments
Take at night - cholesterol synthesis is highest at night so gives the fullest effect
What is the mechanism of action for cholesterol absorption inhibitors?
inhibits absorption of cholesterol secreted in bile and food
what pregnancy category are cholesterol absorption inhibitors?
category X
What are the therapeutic uses for cholesterol absorption inhibitors?
use in adjunct with statins and to help decrease LDL levels
why would a cholesterol absorption inhibitor be used in adjunct with a statin?
If you use a low dose of both you will still get the therapeutic effect of both, but with less risk for adverse effects.
What are some adverse effects of cholesterol absorption inhibitors?
hepatotoxicity (less than statins)
myopathy
What are some primary nursing considerations for cholesterol absorption inhibitors?
obtain baseline liver functions and monitor for signs of liver failure
risk may increase if taking with statins depending on dosages
Obtain baseline CK levels and advise client to report and muscle aches, pain, or tenderness
What are some patient teaching points for cholesterol absorption inhibitors?
Avoid pregnancy (cat X)
use two types of birth control including one barrier method
avoid alcohol (liver)
Avoid grapefruit juice (increases toxicity)
reports signs of myopathy and liver failure
keep lab appointments
taking at night doesnt increase effect, however if taking with a statin it would be easiest to keep a schedule by taking both at night
what is the therapeutic action of bile acid sequestrants?
increases the excretion of bile in the stool causing the liver to secrete cholesterol to make more bile.
NOT ABSORBED SYSTEMICALLY
What pregnancy category are bile acid sequestrants in?
Category C/B MAY BE USED IN PREGNANCY
What are the therapeutic uses for bile acid seuquestrants?
use in adjunct to statins to help decrease LDL levels
What are some adverse effects of bile acid sequestrants?
mostly GI (constipation, diarrhea, abd pain, n/v, bloating)
may subside
What are some nursing considerations for bile acid sequestrants?
Increase fluids and fiber for constipation and bloating
administer other medications and vitamins 4 hours before taking, it may inhibit their absorption
Take with food and 8 ounces of water
if its a poder dissolve in 4-8 oz of water
what is the therapeutic action of nicotonic acid? (vitamin B3)
decrease LDL and triglycerides
What are some adverse effects of nicotonic acid?
Facial flushing (most common)
hyperuricemia
hepatotoxicity
What are some nursing considerations for nicotonic acid?
have patient take a baby aspirin 30 minutes before taking to prevent facial flushing in not contraindicated
encourage 2-3l of fluid daily for hyperuricemia (increases uric acid secretion)
monitor kidney function, administer allopurinol if uric acid is elevated
monitor liver function
can be purchased OTC
What pregnancy category is nicotonic acid?
Category C
What is the main action of fibrates?
decreases triglycerides and increases HDLs
What pregnancy category are fibrates?
Category C
What is the main therapeutic use for fibrates?
use in adjunct to statins
pretty much the same as statins but they are used if triglycerides are the main problem
What are some adverse effects of fibrates?
Gallstones
myopathy
hepatotoxicity
what are some nursing considerations for fibrates?
monitor for signs of gallstones (RUQ pain, bloating, n/v, intolerance to fatty foods)
Get a baseline CK and monitor for signs of myopathy
Monitor liver functions and get a baseline, look for signs of liver failure
tell patient to avoid alcohol
take 30 minutes before meals
