Antilipemic Drugs Flashcards

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1
Q

Atorvastatin (Lipitor)

Chemical Classification

A

HMG-CoA reductase inhibitor (statin)

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2
Q

Atorvastatin (Lipitor)

Mechanism of Action

A

Inhibits HMG-CoA reductase enzyme, which reduces cholesterol synthesis; high doses lead to plaque regression

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3
Q

Atorvastatin (Lipitor)

Uses

A

As adjunct for primary hypercholesterolemia (types Ia, Ib), dysbetalipoproteinemia, elevated triglyceride levels, prevention of CV disease by reduction of heart risk in those with mildly elevated cholesterol

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4
Q

Atorvastatin (Lipitor)

Contraindications

A

Pregnancy (X), breastfeeding, hypersensitivity, active hepatic disease

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5
Q

Atorvastatin (Lipitor)

Side Effects

A
CNS: headache, asthenia
EENT: lens opacities
GI: Abdominal Cramps, Constipation, Diarrhea, Flatus, Heartburn, dyspepsia, LIVER DYSFUNCTION, PANCREATITIS, nausea, increased serum transaminase 
GU: impotence
INTEG: rash, pruritus, alopecia; photosensitivity (rare)
MISC: hypersensitivity 
MS: arthralgia, myalgia, RHABDOMYOLYSIS 
RESP: pharyngitis, sinusitis
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6
Q

Atorvastatin (Lipitor)

Nursing Considerations

A

ASSESS:

  • HYPERCHOlESTEROLEMIA: diet, obtain diet history including fat, cholesterol in diet; cholesterol triglyceride levels periodically during treatment; check lipid panel 6-12wk after changing dose
  • Hepatic studies q1-2mo, at initiation, 6,12wk after initiation or change in dose, periodically thereafter; AST, ALT, LFTs may be increased
  • Renal studies in patients with compromised renal system: BUN, I&O ratio, creatinine
  • Bowel status: constipation, stool softeners may be needed; if severe, add fiber, water to diet
  • RHABDOMYOLYSIS: FOR MUSCLE PAIN, TENDERNESS, OBTAIN CPK BASELINE; IF MARKEDLY INCREASED, PRODUCT MAY NEED TO BE DISCONTINUED
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7
Q

Cholestyramine (Questran)

Functional Classification

A

Antilipemic

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8
Q

Cholestyramine (Questran)

Chemical Classification

A

Bile Acid Sequestrant

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9
Q

Cholestyramine (Questran)

Mechanism of Action

A

Absorbs, combines with bile acids to form insoluble complex that is excreted through feces; loss of bile acids lowers LDL, cholesterol levels

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10
Q

Cholestyramine (Questran)

Uses

A

Primary hypercholesterolemia (esp. type IIa/IIb hyperlipoproteinemia), pruritus associated with biliary obstruction

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11
Q

Cholestyramine (Questran)

Contraindications

A

Hypersensitivity; biliary obstruction; hyperlipidemia III, IV, V

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12
Q

Cholestyramine (Questran)

Side Effects

A

CNS: headache, dizziness, drowsiness, vertigo, tinnitus, anxiety
GI: Constipation, Abdominal Pain, Nausea, fecal impaction, hemorrhoids, flatulence, vomiting, steatorrhea, peptic ulcer
HEMA: BLEEDING, increased PT
INTEG: rash, irritation of perianal area, tongue, skin
META: decreased vit A, D, K, red cell folate content; HYPERCHLOREMIC ACIDOSIS
MS: muscle, joint pain

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13
Q

Cholestyramine (Questran)

Nursing Considerations

A

ASSESS:

  • Cardiac glycoside level if both products administered
  • For signs of vit A, D, K deficiency
  • HYPERCHOLESTEROLEMIA: fasting LDL, HDL, total cholesterol, triglyceride levels, electrolytes if receiving extended therapy; diet history
  • PRURITUS: for signs of itching
  • Bowel pattern daily; increase bulk, water in diet for constipation; diarrhea may also occur
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14
Q

Niacin

Functional Classification

A

Vit B3, antihyperlipidemic

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15
Q

Niacin

Chemical Classification

A

Water-soluble vitamin

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16
Q

Niacin

Mechanism of Action

A

Needed for conversion of fats, protein, carbohydrates by oxidation reduction; acts directly on vascular smooth muscle, this causing vasodilation; reduces total cholesterol, LDL, VLDL, triglycerides; increases HDL

17
Q

Niacin

Uses

A

Pellagra, hyperlipidemias (types 4,5), peripheral vascular disease that presents a risk for pancreatitis

18
Q

Niacin

Contraindications

A

Breastfeeding, hypersensitivity, peptic ulcer, hepatic disease, hemorrhage, severe hypotension

19
Q

Niacin

Side Effects

A

CNS: paresthesias, headache, dizziness, anxiety
CV: postural hypotension, vasovagal attacks, dysrhythmias, vasodilation
EENT: blurred vision, ptosis
GI: nausea, vomiting, anorexia, JAUNDICE, HEPATOTOXICITY, diarrhea, peptic ulcer, dyspepsia, HEPATITIS
GU: hyperuricemia, GLYCOSURIA, HYPOALBUMINEMIA
INTEG: flushing, dry skin, rash, pruritus, itching, tingling

20
Q

Niacin

Nursing Considerations

A

ASSESS:

  • Cardiac status: rate, rhythm, quality; postural hypotension, dysrhythmias
  • Nutritional status: liver, yeast, legumes, organ meat, lean poultry; fat in diet
  • HEPATOTOXICITY: clay-colored stools, itching, dark urine, jaundice; hepatic studies: AST, ALT, bilirubin, uric acid, alk phos; blood glucose before and during treatment
  • CNS symptoms: headache, paresthesias, blurred vision
  • NIACIN DEFICIENCY: nausea, vomiting, anemia, poor memory, confusion, dermatitis
  • HYPERLIPIDEMIA: for lipid, triglyceride, cholesterol level; obtain diet history
21
Q

Simvastatin (Zocor)

Functional Classification

A

Antilipemic

22
Q

Simvastatin (Zocor)

Chemical Classification

A

HMG-CoA reductase inhibitor

23
Q

Simvastatin (Zocor)

Mechanism of Action

A

Inhibits HMG-CoA reductase enzyme, which reduces cholesterol synthesis

24
Q

Simvastatin (Zocor)

Uses

A

As an adjunct for primary hypercholesterolemia (types IIa, IIb), isolated hypertriglyceridemia (Frederickson type IV) and type III hyperlipoproteinemia, CAD, heterozygous familial hypercholesterolemia

25
Q

Simvastatin (Zocor)

Contraindications

A

Pregnancy (X), breastfeeding, hypersensitivity, active hepatic disease

26
Q

Simvastatin (Zocor)

Side Effects

A

CNS: headache
GI: nausea, constipation, diarrhea, dyspepsia, flatus, abdominal pain, LIVER DYSFUNCTION, PANCREATITIS
INTEG: rash, pruritus
MS: muscle cramps, myalgia, MYOSITIS, RHABDOMYOLYSIS, myopathy
RESP: upper respiratory tract infection

27
Q

Simvastatin (Zocor)

Nursing Considerations

A

ASSESS:

  • Diet history: fat consumption; baseline and lipid profile: LDL, HDL, TG, cholesterol
  • Hepatic studies at baseline, after 4-6wk, periodically thereafter; AST, ALT, LFTs may increase
  • RHABDOMYOLYSIS: muscle tenderness, increased CPK levels (10x above upper normal limit); therapy should be discontinued
  • Renal studies in patients with compromised renal systems: BUN, I&O ratio, creatinine
28
Q

Atorvastatin (Lipitor)

Functional Classification

A

Antilipidemic