Ch 47 Lipid Lowering Agents

Question 1

what is the function of low density lipoproteins?

Answer 1

transport cholesterol to the peripheral cells

Question 2

what is the function of high density lipoproteins?

Answer 2

take cholesterol from the peripheral cells and transport it to the liver; protects against heart disease

Question 3

what does the elevation of LDLs cause?

Answer 3

atherosclerotic plaque formation, increased risk for heart disease

Question 4

What is considered the “good cholesterol”?

Answer 4

HDL

Question 5

what is included in a lipid panel?

Answer 5

total cholesterol, LDL, HDL, triglycerides

Question 6

What causes hyperlipidemia?

Answer 6

excessive dietary intake of fats, genetic alterations in fat metabolism

Question 7

what does high cholesterol lead to?

Answer 7

atherosclerosis, CAD, heart attack, stroke, hypertension

Question 8

what are modifiable risk factors associated with high cholesterol?

Answer 8

gout, cigarette smoking, sedentary lifestyle, high stress levels, hypertension, obesity, diabetes, untreated bacterial infections, treatment with tetracycline and fluororoentgenography

Question 9

what are non modifiable risk factors?

Answer 9

genetics, age, gender

Question 10

What are the actions of lipid lowering agents?

Answer 10

lower levels of cholesterol
lower levels of lipids
raise levels of HDL
prevent CAD

Question 11

What are medication examples of Bile Acid Sequestrants (Resins)

Answer 11

Cholestyramine, Colestipol (Colestid), Colesevelam (WelChol)

Question 12

What is the action of Bile Acid Sequestrants?

Answer 12

medication binds with bile acids in the intestines, an insoluble complex forms and is excreted in feces; the liver metabolizes cholesterol to increase production of bile acids which lowers the blood cholesterol levels

Question 13

what does Bile Acid Sequestrants treat?

Answer 13

hypercholesterolemia, pruritus

Question 14

Which type of cholesterol is affected with bile acid sequestrants?

Answer 14

LDL

Question 15

what are adverse reactions of Bile Acid Sequestrants?

Answer 15

increased bleeding times, vitamin A and D deficiencies, CNS effects, GI irritation

Question 16

What are the nursing considerations/teaching points of Bile Acid Sequestrants?

Answer 16

no not give to patients with complete biliary obstruction
bile acid sequestrants reduce the effectiveness of Digoxin, Warfarin, Thyroid Hormones, Thiazide Diuretics, and Corticosteroids

Question 17

What is the medication ending of HMG-CoA Reductase Inhibitors?

Answer 17

Statins

Question 18

What are medication examples of HMG-CoA Reductase Inhibitors?

Answer 18

atorvastatin (Lipitor)
pravastatin (Pravachol)
simvastatin (Zocor)

Question 19

what is the action of HMG-CoA Reductase Inhibitors?

Answer 19

HMG-CoA is an enzyme that is a catalyst during the manufacturing of cholesterol. These drugs block the enzyme, therefore blocking the synthesis of cholesterol.

Question 20

What does HMG-CoA Reductase Inhibitors treat?

Answer 20

hyperlipidemia
high triglyceride levels
primary prevention of coronary events

Question 21

What types of cholesterol do HMG-CoA Reductase Inhibitors affect?

Answer 21

lowers the LDL, raises the HDL

Question 22

what are adverse reactions of HMG-CoA Reductase Inhibitors?

Answer 22

liver failure, rhabdomyolysis, CNS effects, GI irritationw

Question 23

what is rhabdomyolysis?

Answer 23

break down muscle mass causing muscle weakness, soreness, and myopathy; shuts kidney’s down long term

Question 24

What should a nurse consider when caring for a patient taking HMG-CoA Reductase Inhibitors?

Answer 24

do not give to anyone with active liver disease, caution in individuals with alcohol abuse tendencies, watch for signs of ascites/liver failure, report symptoms of muscle pain/weakness to HCP

Question 25

What are drug interactions with HMG-CoA Reductase Inhibitors?

Answer 25

Statins increase toxicity of digoxin or warfarin when used in combination

Question 26

What are teaching point for patients taking HMG-CoA Reductase Inhibitors?

Answer 26

take in evening with a meal, photosensitivity can occur (limit sun exposure, wear sunscreen), do not take with grapefruit or its juice, continue taking the drug even if it makes you feel better, report signs of myopathy that leads to rhabdomyolysis

Question 27

what is a medication example of Cholesterol Absorption Inhibitors?

Answer 27

Ezetimible (Zetia)

Question 28

what is the action of Cholesterol Absorption Inhibitors?

Answer 28

works in the brush boarder of the small intestine to inhibit the absorption of cholesterol

Question 29

what does Cholesterol Absorption Inhibitors treat?

Answer 29

hypercholesterolemia, lowers sitosterol and campesterol levels

Question 30

what cholesterol types do Cholesterol Absorption Inhibitors affect?

Answer 30

lowers LDL

Question 31

what are adverse reactions of Cholesterol Absorption Inhibitors?

Answer 31

GI upset, CNS effects, back pain, muscle aches a pains

Question 32

what should a nurse consider when caring for a patients taking Cholesterol Absorption Inhibitors?

Answer 32

caution in individuals with liver disease

Question 33

What are drug interactions with Cholesterol Absorption Inhibitors?

Answer 33

do not give with Cholestyramine
interferes with Fibrates and Warfarin

Question 34

what is Niacin?

Answer 34

vitamin B3

Question 35

how does Niacin work?

Answer 35

inhibits release of free fatty acids from fatty tissue

Question 36

when is niacin given?

Answer 36

often used in addition with other lipid lowering medication

Question 37

what are adverse reactions of niacin?

Answer 37

severe generalized flushing of the skin, warm sensation, severe itching

Question 38

what is the action os Omega-3’s?

Answer 38

fish oil mixtures inhibits liver enzymes to decrease the making of triglycerides