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NURS 251 (Pharmacology 1) > Antilipemic drugs > Flashcards

Antilipemic drugs Flashcards

1
Q

What are the two primary forms of lipids in the blood?

A

Triglycerides and Cholesterol

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2
Q

What are apolipoproteins

A

Specialized lipid-carrying proteins

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3
Q

What is the term for the combo of triglycerides and/or cholesterol with an apolipoprotein?

A

Lipoprotein

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4
Q

What are the 4 subcategories of lipoproteins and what is the “good” one

A

Very low density
Immediate density
Low-density
High-density (good because it recycles cholesterol)

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5
Q

How much greater is the risk of coronary heart disease in patients with cholesterol levels of 5.2 mmol/L compared to those with levels less than 4 mmol/L

A

3-4x

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6
Q

What choosing drug therapy for a patient with dyslipidemia, what tests need to be done first

A

Phenotyping: Determining the specific lipid profile of the patient

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7
Q

What are the 5 established classes of antilipemics

A

Hydroxymethylglutaryl–coenzyme A (HMG–CoA) reductase inhibitors (statins)
Bile acid sequestrants
B vitamin niacin
Fibric acid derivatives
Cholesterol absorption inbitor

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8
Q

How do statins/HMG-CoA reductase inhibitors treat hypercholesterolemia

A

Decreases rate of cholesterol production.
When less is produced, the liver increases the number of LDL receptors to recycle LDL from circulation back into the liver where it is needed for synthesis of steroids, bile and cell membranes

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9
Q

What is the suffix for (HMG–CoA) reductase inhibitors (statins)

A

“statin”

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10
Q

Name 2 HMG-CoA reductase inhibitors (Statins)

A

Atorvastatin
Rosuvastatin sodium

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11
Q

What are the adverse effects of HMG-CoA reductase inhibitors (statins)

A

Mild GI disturbances
Rash
Headache
Myopathy
Rhabdomyolysis

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12
Q

What is rhabdomyolysis and what are the signs?

A

Breakdown of muscle proteins and urinary elimination of the muscle protein myoglobinuria that can lead to acute kidney injury and death
Usually reversible when caught early and the drug is discontinued
Signs are muscle soreness or changes in urine colour to tea-coloured

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13
Q

What are drug interactions with statins

A

Anticoagulants,
Erythromycin,
HIV and Hep C protease inhibitors
Grapefruit
Clarithromycin
Amlodipine

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14
Q

How and when are atorvastatin calcium and rosuvastatin taken

A

Once daily, usually with the evening meal or at bedtime

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15
Q

Name a bile acid sequestrant and what else they can be called

A

Cholestyramine resin
AKA bile acid-binding resins or ion-exchange resins

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16
Q

What is the MOA of bile acid sequestrants

A

Prevent reabsorption of bile acids from SI (bile absorbs cholesterol). The more bile acids are excreted, the more the liver converts cholesterol to bile acids, removing it from circulation

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17
Q

What are the indications for bile acid sequestrants?

A

Type 2 Hyperlipoproteinemia
Relief of pruritus (itching) from biliary obstruction
Used in adjunct with statins

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18
Q

What are the adverse effects of bile acid sequestrants

A

Constipation
Heartburn
Nausea
Burping
Bloating
Mild increase in triglyceride levels

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19
Q

Overdose can cause ______ because the bile acid sequestrants are not absorbed.

A

obstruction

20
Q

What is a consideration to make about the timing of administering bile acid sequestrants

A

All other drugs must be taken 1 hour before or 4-6 hours after admin of bile acid sequestrants

21
Q

What can high doses of bile acid sequestrants cause

A

Decrease the absorption of fat soluble vitamins (A,D,E,K)

22
Q

What are the contraindications of cholestyramine resin

A

Complete biliary obstruction
Pregnancy and lactation
Diarrhea treatments

23
Q

What is the MOA of niacin

A

Inhibits lipolysis in adipose tissue
Decreases esterification of triglycerides in the liver
Increases activity of lipase
Reduces metabolism of cholesterol and triglycerides
As a result: Decreased triglyceride, LDL levels and increased HDL levels
Also breaks down fibrin clots

24
Q

What is another name for niacin

A

Vitamin B3
Nicotinic acid

25
Q

What are the indications for niacin

A

Effective and inexpensive way to lower LDL and triglyceride levels

26
Q

When are the therapeutic and maximum effects of niacin

A

Therapeutic: 1-4 days
Maximum: 3-5 weeks

27
Q

What are the contraindications of niacin

A

Peptic ulcer disease, HTN, active hemorrhagic process

28
Q

What are the adverse effects of niacin

A

Flushing, Pruritus, GI distress

29
Q

What is another name for fibric acid derivates and name 1 example

A

Gemfibrozil
AKA fibrates

30
Q

What is the MOA of fibric acid derivatives

A

Activates lipoprotein lipase to break down cholesterol
Suppresses the release of fatty acids from adipose tissue
Inhibits synthesis of triglycerides in the liver
Increases secretions of cholesterol in the bile

31
Q

What are the indications for fibrates?

A

Types 3, 4 and 5 hyperlipidemias
Can decrease HDL level by as much as 25%

32
Q

What are the contraindications for fibrates

A

Allergy
Sever liver or kidney disease
Cirrhosis
Gallbladder disease

33
Q

What are the adverse effects of fibric acid derivatives?

A

Abdominal discomfort
Diarrhea
Blurred vision
Headache
Prolonged prothrombin time
Increased risk of gallstones
Increased enzyme levels

34
Q

What are the drug interactions with Gemfibrozil

A

Enhances anticoagulants
Always given with statins which increases the risk of myositis, myalgia, and rhabdomyolysis

35
Q

What results would you expect to see in a blood test of a patient taking fibric acid derivatives

A

Decreased Hb, hematocrit and WBC
Increased aspartate aminotransferase (AST), activated clotting time, lactate dehydrogenase and bilirubin level

36
Q

Name 1 cholesterol absorption inhibitor

A

Ezetimibe

37
Q

What is the MOA of cholesterol absorption inhibitor

A

Inhibits absorption of cholesterol in SI
Reduces total LDL, apolipoprotein and triglycerides levels
Increases HDL

38
Q

What treatments can garlic be used for?

A

Antispasmodic, antiseptic, antibacterial, antiviral, antihypertensive, antiplatelet, lipid reducer

39
Q

What are the adverse effects of garlic

A

Dermatitis, vomiting, diarrhea, anorexia, flatulence, decrease coagulation

40
Q

What are possible drug interactions with garlic

A

Warfarin, Diazepam, Protease inhibitors
May enhance bleeding when taken with NSAIDs

41
Q

What are the indications for flax

A

Atherosclerosis, Hypercholesterolemia, Hypertriglyceridemia, GI distress, Menopausal symptoms, Bladder inflammation

42
Q

What are adverse effects and possible interactions with flax

A

Diarrhea and allergic reactions;
Antihyperglycemic drugs and anticoagulants

43
Q

what are adverse effects, interactions and contraindications and indications for omega 3 fatty acids

A

They reduce cholesterol
May cause rash, belching, allergic reactions
May interact with anticoagulants
Contraindicated in pregnancy

44
Q

Patients on long-term therapy of antilipemics may need __________________

A

supplemental fat-soluble vitamins (A, D, E, K).

45
Q

T/F: Powder forms must be taken with a liquid that is stirred or it should be taken dry

A

False: It should be mixed thoroughly but not stirred, and never taken dry

46
Q

What can be taken 30 minutes before niacin to minimize flushing

A

Small doses of aspirin or NSAIDs

NURS 251 (Pharmacology 1) (20 decks)

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