Antilipemic Drugs Flashcards
Atorvastatin (Lipitor)
Chemical Classification
HMG-CoA reductase inhibitor (statin)
Atorvastatin (Lipitor)
Mechanism of Action
Inhibits HMG-CoA reductase enzyme, which reduces cholesterol synthesis; high doses lead to plaque regression
Atorvastatin (Lipitor)
Uses
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
Atorvastatin (Lipitor)
Contraindications
Pregnancy (X), breastfeeding, hypersensitivity, active hepatic disease
Atorvastatin (Lipitor)
Side Effects
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
Atorvastatin (Lipitor)
Nursing Considerations
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
Cholestyramine (Questran)
Functional Classification
Antilipemic
Cholestyramine (Questran)
Chemical Classification
Bile Acid Sequestrant
Cholestyramine (Questran)
Mechanism of Action
Absorbs, combines with bile acids to form insoluble complex that is excreted through feces; loss of bile acids lowers LDL, cholesterol levels
Cholestyramine (Questran)
Uses
Primary hypercholesterolemia (esp. type IIa/IIb hyperlipoproteinemia), pruritus associated with biliary obstruction
Cholestyramine (Questran)
Contraindications
Hypersensitivity; biliary obstruction; hyperlipidemia III, IV, V
Cholestyramine (Questran)
Side Effects
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
Cholestyramine (Questran)
Nursing Considerations
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
Niacin
Functional Classification
Vit B3, antihyperlipidemic
Niacin
Chemical Classification
Water-soluble vitamin