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Pharm Exam 4 > CH 23: Lipid disorders > Flashcards

CH 23: Lipid disorders Flashcards

1
Q

3 types of lipids

A

 Triglycerides
 Phospholipids
 Steroids

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2
Q

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

A

triglycerides

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3
Q

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

A

phospholipids

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4
Q

most widely known steroids

A

cholesterol

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5
Q

lipid strongly associated with atherosclerosis

A

steroids

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6
Q

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

A

to 5–6% of total calories.

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7
Q

transport lipids through the bloodstream

A

lipoproteins

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8
Q

3 most common lipoproteins

A

HDL
LDL
VLDL

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9
Q

bad cholesterol

A

LDL

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10
Q

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

A

LDL

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11
Q

LDL leads to

A

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

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12
Q

reducing LDL has been shown to decrease

A

incidence of coronary artery disease

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13
Q

 The primary carrier of triglycerides
 Can turn into LDL

A

VLDL

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14
Q

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

A

reverse cholesterol transport

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15
Q

interacts with bile and excreted into the feces

A

HDL

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16
Q

why is HDL considered good cholesterol

A

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

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17
Q

high levels of lipid

A

hyperlipidemia

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18
Q

form of hyperlipidemia

A

hypercholesterolemia

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19
Q

abnormal levels of lipoproteins

A

dyslipidemia

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20
Q

contributors of hyperlipidemia

A

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

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21
Q

diagnostics of hyperlipidemia

A

 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

22
Q

total cholesterol level too high

A

above 240

23
Q

LDL cholesterol levels too high

A

above 160

24
Q

HDL cholesterol levels

A

less than 40 for men
less than 50 for women

25
Q

serum triglycerides level too high

A

150-500

26
Q

controlling lipid levels with lifestyle

A

 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

27
Q

drugs for lipid level control

A

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

28
Q

Inhibit cholesterol synthesis

A

HMG-COA Reductase Inhibitors (STATINS)

29
Q

Cholesterol binds with bile acids and increases excretion

A

Bile Acid Sequestrants

30
Q

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

A

Niacin: vitamin

31
Q

reduces available LDL receptors in the liver
only for familial

A

Monoclonal antibodies (mabs)

32
Q

therapeutic effects of atorvastatin

A

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

33
Q

adverse effects of atorvastatin

A

intestinal cramping
diarrhea
constipation
are common during therapy

34
Q

adverse effects of statins

A

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

35
Q

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

A

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

36
Q

therapeutic effects of cholestyramine (Bile Acid Sequestrants)

A

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

37
Q

adverse effects of cholestyramine (Bile Acid
Sequestrants)

A

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

38
Q

monitoring and safety for cholestyramine (Bile Acid Sequestrants)

A

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

39
Q

therapeutic effects for ezetimibe (Cholesterol absorption inhibitors)

A

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

40
Q

adverse effects ezetimibe (Cholesterol
absorption inhibitors)

A

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

41
Q

therapeutic effects of Niacin (vitamin)

A

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

42
Q

adverse effects of Niacin (vitamin)

A

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

43
Q

safety precaution for niacin (vitamin)

A

do not attempt to self medicate with OTC

44
Q

therapeutics effects of monoclonal antibodies (mabs)

A

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

45
Q

adverse effects of monoclonal antibodies

A

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

46
Q

administration of mabs

A

given subq

46
Q

administration of mabs

A

given subq

47
Q

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.

A

rhabdomyolysis

48
Q

anticoagulant

A

warfarin

49
Q

therapeutic effects of Gembibrozil (Fibric Acid Drugs)

A

Lower VLDL lipid levels
Lower high triglyceride levels
Increases HDL

50
Q

adverse effects of Gembibrozil (Fibric Acid Drugs)

A

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

51
Q

safety and monitoring for Gembibrozil (Fibric Acid Drugs)

A

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

Pharm Exam 4 (7 decks)

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