Antilipemic, Antianginal, Coagulation Modifier drugs (Week 2) Flashcards
Define Antipemic
A drug that reduces lipid levels
HMG-CoA Reductase inhibitors suffix
“statins”
HMG-CoA Reductase inhibitors Theraputic Effect
Lower the Blood cholesterol level by decreasing the rate of cholesterol production.
HMG-CoA Reductase inhibitors MOA
Inhibit the enzyme HMG-CoA Reductase, and decrease cholesterol production.
The liver requires HMG-CoA Reductase to produce cholesterol so ^^^
HMG-CoA Reductase inhibitors Indications
First line drug therapy for hypercholesterolemia (most common and dangerous form of dyslipidemia)
HMG-CoA Reductase inhibitors Contraindications
Drug allergy, pregnancy, liver disease or increase liver enzymes
HMG-CoA Reductase inhibitors AE
Typically well Tolerated.
Common: Mild transient gastrointestinal disturbances and headache
Less common: myopathy (muscle pain) which can progress to rhabdomyolysis ( breakdown of muscle protein).
HMG-CoA Reductase inhibitors Drug interactions
Should be cautioned for pts taking anticoagulants.
Limit drinking of grapefruit juice to 1 L
Name 4 antilipemic drugs
HMG-CoA Reductase inhibitors
Bile Acid Sequestrants
Nicotinic Acid
Fibric Acid Derivatives.
Bile Acid Sequestrants Theraputic Effects
Lower the plasma concentrations of LDL by 15-30% and increase HDL cholesterol by 3-8% and increase liver triglyceride production
Bile Acid Sequestrants MOA
Bile Acid resins bind bile, preventing the reabsorption of bile acids from sm intestine.
Bile acids are necessary for the absorption of cholesterol from the sm intestine
Bile Acid Sequestrants Indications
Primary or adjunct therapy in the management of hyperlipoproteinemia
Bile Acid Sequestrants Contraindications
Drug allergy and bowel or biliary obstruction
Bile Acid Sequestrants AE
Common: Constipation accompanied by heartburn, nausea, belching and bloating
Bile Acid Sequestrants Interactions
High doses of Bile Acid Sequestrants will decrease the absorption rate of fat solubles (Vit A,D,E,K)
Nicotinic Acid MOA
Is a vitamin B that inhibits lipolysis in adipose tissue, decrease esterfication of triglycerides in the liver and increase the activity of lipoprotein lipase.
Nicotinic Acid Theraputic effects
Decrease LDL by 10-20%, decrease triglycerides from 30-70% and increase HDL by 20-35%.
Nicotinic Acid Indications
> > Types IIa, IIb, II, IV, V hyperlipidemia
Nicotinic Acid Contraindications
drug allergy, liver disease, htn, peptic ulcer, active hemorrhagic process
Nicotinic Acid AE
Flushing, pruritus, and GI distress.
Take drug with meals to minimize undesired effects
Fibric Acid Derivatives (FIBRATES) Theraputic Effects
Decrease LDL N Raise HDL
Fibric Acid Derivatives (FIBRATES) MOA
- Activate lipoprotein lipase, enzyme responsible for breaking down cholesterol
- Suppress release of of free fatty acid from adipose tissue
- inhibit synthesis of triglycerides in liver and increase secretion of cholesterol into bile
Fibric Acid Derivatives (FIBRATES) Indications
IIa,IIb, IV, and V type of hyperlipidemias
Fibric Acid Derivatives (FIBRATES) Contraindications
Drug allergies, severe kidney/liver disease, cirrhosis or gallbladder disease
Fibric Acid Derivatives (FIBRATES) AE
Common: abdominal discomfort, diarrhea nausea, headache, blurred vision, increase risk for gallstones and prolonged prothrombin time.
Key Patient education tips for Antilipemic drugs
-Notify Health care provider if there is any persistant:
GI upset, constipation, gas, bloating, heartburn, nausea, vomiting, abnormal or unusual bleeding
-Encourage pts to drink 2000 ml of fluids/day
-Encourage to exercise with supervision first d/t possible dizziness
Name the 3 main Antianginal Drugs
Nitrates/Nitrites
B-Blockers
Calcium Channel Blockers
Nitrates/Nitrites MOA
Dilate all blood vessels. Dominantly affect venous vascular beds. Dilation allows venous return and reduces preload of left ventricular end- diastolic volume
Nitrates/Nitrites Indications
Stable, Unstable and Vasospastic (Prinzmetal’s) angina.
Nitrates/Nitrites Contraindications
Drug allergy, severe anemia, closed angle glaucoma, hypotension, or severe head injury
Nitrates/Nitrites AE
Mostly well tolerated.
Most common: headache, tachycardia, and postural hypotension, reflex tachycardia (if nitrate vasodilation happens too fast)
Nitrates/Nitrites Interactions
Produce hypotensive effects if taken with
alcohol, calcium channel blockers, phenothiazines and erectile dysfunction drugs
B-Blockers MOA
Decreases the heart rate, Decrease BP and suppress the hormone renin from being released
B-Blockers Indications
Angina, MI and HTN
B-Blockers Contraindications
Systolic heart failure, and conduction disturbances
Caution in the use of pts with bronchial asthma
B-Blockers AE
CV: brady/tachy cardia, hypotension, 2nd or 3rd degree heart block, heart failure
CNS: dizzy, fatigue, drowsy, mental depresssion, lethargy, unusual dreams
Calcium Channel Blockers MOA
- Decrease muscle contractions and allows for muscle relaxation
- Relaxation= dilation which allows increase blood flow to the heart, increasing o2 supply.
Calcium Channel Blocker Indications
First line drug for angina, HTN, and supraventricular tachycardia.
Calcium Channel Blocker Contraindications
drug allergy, acute MI, second or third atrioventricular block (unless pt has a pace maker) and hypotension
Calcium Channel Blocker AE
CV: hypotension, palpitations, tachycardia or bradycardia, heart failure
GI: constipation nausea
Calcium Channel Blocker Drug Interactions
B-Blockers- additive effects and results bradycardia or atrioventricular block
Digoxin- Interferes with elimination and results increased digoxin levels
H2 blockers- decreases H2 and results increase of calcium channel blockers
Patient Education For Nitroglycerin
- Instruct pt to have journal to keep track of when anginal episodes occur, intensity of pain, frequency and factors that relieve pain
- Keep away from moisture, light, heat
- Blurred vision, dry mouth or severe headaches may indicate drug overdose= IMMEDIATE MED ATTENTION
- Take med before stressful sitations
