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Pharm 2 Exam 1 > Chapter 16 > Flashcards

Chapter 16 Flashcards

1
Q

Name the different types of drug therapies for Cholesterol Managment

A 
HMG-CoA reductase inhibitors
Bile-acid sequestrants
Cholesterol absorption inhibitors
Fibrates
Nicotine acids
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2
Q

How do HMG-CoA reductase inhibitors work

A

they control the rate of cholesterol produced by the liver which decreases total cholesterol, decreases LDL and decreases triglycerides

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3
Q

What is the suffix of HMG-CoA reductase inhibitors

A

statin
atorvastatin
simvastatin

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4
Q

What are the side effects of statin drugs

A

muscle aches, GI upset, liver problems

usually they go away

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5
Q

What are the adverse effects of statins

A

Decreased liver fx, need a liver test q 3-6months, Rhabdomyolysis which can lead to kidney failure

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6
Q

what do you check before giving statin drugs

A

kidney and liver function, check for muscle problems and alcohol consumption

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7
Q

What do you check after giving statin drugs

A

liver function and assess for muscle breakdown

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8
Q

What do you teach your patient about statin drugs

A

Can take them at bedtime if it upsets their stomach, or they can be taken twice per day

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9
Q

Lifespan considerations for statin drugs

A

not for children under 8, not for pregnancy (X), not for patients with myopathy or liver disease

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10
Q

What is the suffix of Bile Acid Sequestrants

A

cole
cholestyramine
colesevelam
colestipol

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11
Q

What are side effects of Bile Acid

A

GI upset

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12
Q

What are adverse effects of Bile Acid (cole)

A

decrease in body’s ability to absorb oral drugs, inhibit fat soluble vitamins (A,D,E, and K) they may need a vitamin supplement, can increase or decrease the effects of warfarin

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13
Q

What do you check before you give Bile Acid (cole)

A

Give at least 2 hours before or 4-6 hours after taking other oral drugs, watch for problems with constipation

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14
Q

What do you check after you take Bile Acid (cole)

A

assess for constipation, and other GI problems, if patient is taking warfarin, monitor for s/s of bleeding (clammy, easily bruising, paleness, dizziness, increased HR, decreased BP, SOB, or confusion)

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15
Q

What do you teach your patients taking Bile Acid (cole)

A

Take at least 2 hours before taking other oral medications or 4-6 hours after, tablet forms should be taken with 12-16oz of water (to prevent bowel obstruction), take WITH meals so that it can bind with the cholesterol, and take 2 hours before/after antacids

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16
Q

What Bile Acid is safe for pregnant women

A

Colestipol

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17
Q

What is the suffix for Cholesterol Absorption Inhibitors

A

EZE

esetimible

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18
Q

When are Cholesterol Absorption Inhibitors used

A

when low fat/low cholesterol diets didn’t work, or when statins side effects were too bad, they can also be paired with statin

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19
Q

What are the side effects of Cholesterol Absorption Inhibitors (eze)

A

GI discomfort, diarrhea, rash, fatigue, back pain, joint pain, and sinusitis

20
Q

What are the adverse effects of Cholesterol Absorption Inhibitors (EZE)

A

Angioedema, liver problems

21
Q

What does Cholesterol Absorption Inhibitors do

A

Lower LDL and total cholesterol

22
Q

What do you check before you give Cholesterol Absorption Inhibitors (eze)

A

liver disease or muscle disorders

23
Q

What do you teach the patient taking Cholesterol Absorption Inhibiting (eze)

A

report muscle pain, tenderness or weakness, take drug once a day at the same time, which will help you remember to take the medication and it can help time intestinal problems

24
Q

Lifespan considerations for Cholesterol Absorption Inhibitors

A

Not safe for children under 10, not for pregnant or breast feeding patients

25
Q

Bile Acid binds with cholesterol where?

A

In the intestine, which prevents fat absorption, so you poop it out

26
Q

What is the suffix for Fibrates

A

fib
fenofibrate
gemfibrozil

27
Q

How do fibrates (fib) work

A

They bind to the cell wall receptors and break down lipids for elimination

28
Q

What do Fibrates do to cholesterol

A

decrease trigs and liver production of trigs

increase (mildly) HDL, use of trigs by fat tissues, cholesterol excretion in bile

29
Q

What are some side effects of Fibrates

A

GI upset, dyspepsia, muscle problems, rash, pruritis

30
Q

What are the adverse effects of Fibrates

A

gallstones, rhabdomyolysis, liver damage

31
Q

What does Fibrates interact with

A

grapefruit juice, alcohol, increases warfarin which increases bleeding

32
Q

What do you check before you give Fibrates

A

kidney, liver or gallbladder disease

33
Q

What do you check after giving Fibrates

A

monitor kidney, liver or gallbladder, bleeding

34
Q

What do you teach patients taking Fibrate

A

follow up lab tests, take 30 minutes before morning and evening meals, avoid alcohol, no grapefruit juice, report s/s of bleeding, Older adults will get INR tested weekly

35
Q

What is the Nicotinic Acid Agent

A

Niacin (Vitamin B)

36
Q

What are the intended responses for Niacin

A

decrease trig, total and LDL, increase HDL by dilating blood vessels

37
Q

What are the side effects of Niacin

A

flushing, itching, GI upset, headache, tachy, dizziness, nasal inflammation, hot flashes, SOB, sweating and swelling

38
Q

What are the adverse affects of Niacin

A

Liver failure, Gout, Hyperglycemia

39
Q

What are the contraindications for Niacin

A

Not for patients with hypertension, peptic ulcer disease, or active bleeding

40
Q

What do you check before you give Niacin

A

baseline vitals, blood sugar, BP and HR, history of liver disease, diabetes, alcohol intake and gout

41
Q

What do you teach about Niacin

A

Take with meals, tell your dentist, take NSAID or aspirin 30 minutes prior to taking Niacin to reduce flushing and hot flashes

42
Q

Cholesterol is good for your body (T/F)

A

True

43
Q

Which lipid is considered the “good” lipid

A

HDL

44
Q

The use of lipid lowering drugs lessens the importance of implementing dietary changes in preventing coronary artery disease (t/f)

A

False

45
Q

The side effects of statins disapear as the body adjusts to the medication (T/F/)

A

True

46
Q

What are the normal levels of: Total Cholesterol, Trigs, LDL, and HDL

A

Total: 200 or less
Trigs: 40-160, 35-135
LDL: 60-180
HDL greater than 45, 55

47
Q

When should drug therapy be used for cholesterol?

A

Drugs should only be used if TLC’s (Therapeutic lifestyle changes) fail.

Pharm 2 Exam 1 (3 decks)

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