Bile Acid Sequestrants

Question 1

Bile Acid Sequestrants

Drug Names

Answer 1

Cholestyramine
Colestipol
Colesevelam

Question 2

Indications

Answer 2

Decrease plasma cholesterol levels in primary hypercholesterolemia
Pruritis associated with partial biliary obstruction

Question 3

Mechanism of Action

Answer 3

Binds bile acids in the intestine, allows excretion in feces instead of reabsorption, causes cholesterol to be iodized in the liver, and serum cholesterol levels to fall

Question 4

Contraindications

Answer 4

Allergy
Complete biliary obstruction; Abnormal intestinal function
Pregnancy/lactation

Question 5

Adverse Effects

Answer 5

CNS: headache, anxiety, fatigue, and drowsiness
Direct GI irritation: nausea, constipation
Vitamin A, D, E, and K deficiencies: increased bleeding times

Question 6

Drug-Drug Interactions

Answer 6

Malabsorption of fat-soluble vitamins

Affects absorption of other drugs

Question 7

Assessment

Answer 7

HX: allergy, pregnancy/lactation
Impaired intestinal function/obstruction
Physical: Baseline; skin, CNS, GI system, vitals, weight
Labs: cholesterol, lipid levels, possibly clotting factors