CH 23: Lipid disorders

Question 1

3 types of lipids

Answer 1

 Triglycerides
 Phospholipids
 Steroids

Question 2

 90% of the lipids in the body
 Major storage form of fat in the body
 Serves as an important energy source

Answer 2

triglycerides

Question 3

 Essential to building plasma membranes
 Best known are the lecithins found in high concentration in egg yolks and soybeans

Answer 3

phospholipids

Question 4

most widely known steroids

Answer 4

cholesterol

Question 5

lipid strongly associated with atherosclerosis

Answer 5

steroids

Question 6

The American Heart Association (AHA) recommends that the intake of saturated fat be limited to

Answer 6

to 5–6% of total calories.

Question 7

transport lipids through the bloodstream

Answer 7

lipoproteins

Question 8

3 most common lipoproteins

Answer 8

HDL
LDL
VLDL

Question 9

bad cholesterol

Answer 9

LDL

Question 10

transports cholesterol from the liver to the tissues and organs, used by the body

Answer 10

LDL

Question 11

LDL leads to

Answer 11

plaque buildup and atherosclerosis – a MAJOR contributor to coronary artery disease

Question 12

reducing LDL has been shown to decrease

Answer 12

incidence of coronary artery disease

Question 13

 The primary carrier of triglycerides
 Can turn into LDL

Answer 13

VLDL

Question 14

HDL manufactured in the liver and small intestine and assists in the transport of cholesterol away from the body tissues and back to the liver i

Answer 14

reverse cholesterol transport

Question 15

interacts with bile and excreted into the feces

Answer 15

HDL

Question 16

why is HDL considered good cholesterol

Answer 16

it transports cholesterol for destruction and removes it from the body,

Question 17

high levels of lipid

Answer 17

hyperlipidemia

Question 18

form of hyperlipidemia

Answer 18

hypercholesterolemia

Question 19

abnormal levels of lipoproteins

Answer 19

dyslipidemia

Question 20

contributors of hyperlipidemia

Answer 20

diets high in saturated fats, trans fats, and refined carbohydrates, and lack of exercise

Question 21

diagnostics of hyperlipidemia

Answer 21

 LDL and HDL
 Ratio LDL/HDL greater than 5 for men and greater than 4.4 for women = increased risk for CV
 Total cholesterol greater than 240
 LDL greater than 160 start treatment with STATINS

Question 22

total cholesterol level too high

Answer 22

above 240

Question 23

LDL cholesterol levels too high

Answer 23

above 160

Question 24

HDL cholesterol levels

Answer 24

less than 40 for men
less than 50 for women

Question 25

serum triglycerides level too high

Answer 25

150-500

Question 26

controlling lipid levels with lifestyle

Answer 26

 Know your numbers through regular checks – bloodwork  Weight control  Exercise  Reduce saturated fats, trans fats, and cholesterol  Increase fiber = soluble fiber in the diet, such as that found in oat bran, apples, beans, and broccoli.  No tobacco use

Question 27

drugs for lipid level control

Answer 27

 HMG-COA Reductase Inhibitors (STATINS)  Bile Acid Sequestrants  Fibric Acid Drugs  Others (mabs, mibes, cins, esters)

Question 28

Inhibit cholesterol synthesis

Answer 28

HMG-COA Reductase Inhibitors (STATINS)

Question 29

Cholesterol binds with bile acids and increases excretion

Answer 29

Bile Acid Sequestrants

Question 30

Blocks the enzyme responsible for making cholesterol in the liver. Increases HDL

Answer 30

Niacin: vitamin

Question 31

reduces available LDL receptors in the liver only for familial

Answer 31

Monoclonal antibodies (mabs)

Question 32

therapeutic effects of atorvastatin

Answer 32

-Reduces LDL -Reduces risk for MI and Stroke -Prevention of cardiovascular disease

Question 33

adverse effects of atorvastatin

Answer 33

intestinal cramping diarrhea constipation are common during therapy

Question 34

adverse effects of statins

Answer 34

Diarrhea, abdominal cramping, arthralgia, nasopharyngitis Rhabdomyolysis, severe myositis, elevated hepatic enzymes,

Question 35

monitoring and safety of atrovastatin (HMG-CoA reductase inhibitors)

Answer 35

Requires 2 weeks to start working Administer WITH food Can be taken any time of day Lots of interactions: digoxin toxicity possible Increases oral contraceptives Erythromycin (macrolide) can increase atorvastatins by 40% - When given with macrolides, cyclosporine, and niacin - can lead to rhabdomyolosis * Avoid alcohol – effects liver function

Question 36

therapeutic effects of cholestyramine (Bile Acid Sequestrants)

Answer 36

Reduces LDLoften used in combination with statins – No systemic effects Powder mixed with water or other beverages or mixed with applesauce

Question 37

adverse effects of cholestyramine (Bile Acid Sequestrants)

Answer 37

Constipation, nausea, vomiting, abdominal pain, bloating, dyspepsia Gastrointestinal (GI) tract obstruction, vitamin deficiencies due to poor absorption

Question 38

monitoring and safety for cholestyramine (Bile Acid Sequestrants)

Answer 38

Monitor for Manifestations of nutrient depletion may include May take 30 days to work Drink or eat immediate after mixing to avoid GI obstruction or irritation Use 2 hours before or 4 hours after other drugs May decrease levels of vitamin K and decrease Warfarin levels** DO NOT take with food may cause malabsorption of essential nutrients: beta-carotene, calcium, folic acid, iron, magnesium, vitamin B12, vitamin D, vitamin E, vitamin K, and zinc

Question 39

therapeutic effects for ezetimibe (Cholesterol absorption inhibitors)

Answer 39

Blocks absorption of cholesterol in the small intestine Given with statins Reduces LDL

Question 40

adverse effects ezetimibe (Cholesterol absorption inhibitors)

Answer 40

Nasopharyngitis myalgia upper respiratory tract infection arthralgia diarrhea are the most common

Question 41

therapeutic effects of Niacin (vitamin)

Answer 41

More adverse effects than statins and less effective Lower VLDL and then lowers LDL Reduces triglyceride levels Increases HDL levels

Question 42

adverse effects of Niacin (vitamin)

Answer 42

Flushing, nausea, pruritus, headache, bloating, diarrhea Dysrhythmias

Question 43

safety precaution for niacin (vitamin)

Answer 43

do not attempt to self medicate with OTC

Question 44

therapeutics effects of monoclonal antibodies (mabs)

Answer 44

inhibits a protein and reduces the number of LDL receptors in the liver is reduced and more LDL is excreted from the body

Question 45

adverse effects of monoclonal antibodies

Answer 45

itching, swelling, pain, or bruising at the injection site; nasopharyngitis; flu.

Question 46

administration of mabs

Answer 46

given subq

Question 46

administration of mabs

Answer 46

given subq

Question 47

occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death.

Answer 47

rhabdomyolysis

Question 48

anticoagulant

Answer 48

warfarin

Question 49

therapeutic effects of Gembibrozil (Fibric Acid Drugs)

Answer 49

Lower VLDL lipid levels Lower high triglyceride levels Increases HDL

Question 50

adverse effects of Gembibrozil (Fibric Acid Drugs)

Answer 50

Myalgia, flulike syndrome, nausea, vomiting, increased serum transaminase and creatinine levels Rhabdomyolysis, cholelithiasis, pancreatitis

Question 51

safety and monitoring for Gembibrozil (Fibric Acid Drugs)

Answer 51

Monitor Hgb, Hct, WBC Give with meals to decrease GI distress Can increase the chance of gallstones Contraindicated for people with liver disease, CKD, gallbladder disease Oral anticoagulant effects may increase Do not use with statins May increase effects of some antidiabetic drugs