Ch 28 lipid level Flashcards
What are serum lipids
Fats found in the blood stream
What is the optimal lipid level ( LDL)
100
What are lipids
Cholesterol
Cholesterol esters ( compounds)
They are transported in the blood as part of large molecules among the lipids in the bloodstream and in all the body’s cells
Where is almost all of the cholesterol made
Mostly in the liver
What does cholesterol a role in
It plays a role in forming cell membranes, some hormones, and other needed tissues
What is hyperlipidemia
An elevation of blood lipid levels
It is considered a risk factor for the following disorders;
Atherosclerosis, CAD, and thrombosis.
What is the ideal total cholesterol level
Less than 200
What is the ideal LDL level
100
What is the ideal HDL level
40-59
What are statins
They are drugs that lower blood cholesterol levels
Statins can lower LDL cholesterol levels by 20-60% when given at there maximum dose.
Statins also raise HDL levels by 5-10%
They also lower triglycerides by 10-33%
Whatnots the prototype drug of statins
Lovastatin ( Mevacor)
What does lovastatin do
It does not allow for the synthesis of cholesterol by inhibiting HMG-CoA reductase which is the enzyme that catalyzes cholesterol synthesis
What are contraindications and precautions of lovastatin
Active liver disease
Pregnancy
What are adverse effects of lovastatin
Muscle and joint aches, weakness, cramps, muscle damage, liver damage, and rhabdomyolysis ( destruction of muscle tissue which will destroy the kidney.)
Impotence is also a problem
What pregnancy category is lovastatin
X
What labs should be checked when administering lovastatin
Creatinine levels for muscle destruction
How can one maximize the therapeutic effects of lovastatin
It is most effective when taken at night because cholesterol is synthesized at night
Immediate release is given after the evening meal
Extended release given at bedtime
What should a nurse remember about lovastatin
Warn pt that urine may become brown
Avoid direct sunlight
How can minimize adverse effects of lovastatin
Liver function tests ( AST, ALT) results should be monitored before starting therapy
Evaluate the pt carefully for muscle soreness, tenderness, or pain and CK ( creatinine kinase) levels.
What is ezetimibe ( Zetia)
An anti lipid drug that is used to treat hypercholesterolemia
It’s pediatric use is limited to children older than 10.
It is given orally Qday
It reduces LDL but has no effect on HDL or triglycerides
What is nicotinic acid ( niacin, vitamin B3)
It is used to treat hyperlipidemia
It lowers triglycerides and LDL while increasing HDLs.
What are contraindications of nicotinic acid ( niacin, vitamin B3)
Hepatic dysfunction Active peptic ulcer disease Severe hypotension And hemorrhaging Larger doses produce peripheral vasodilation mostly in the cutaneous vessels of the face, neck, and chest.
What are bile acid sequestrants
Cholestyramine ( LoCholest, Questran, Prevalite) and colestipol ( Colestid) are used to reduce elevated serum cholesterol levels in ppl with primary hypercholesterolemia who have not responded to other therapies.
They are not absorbed orally but work in the GI tract.
It reduces LDL noticeably within 4-7 days
It hey promote oxidation of cholesterol to bile acids
