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NURS 306 > Chapter 27: Antilipemic Drugs > Flashcards

Chapter 27: Antilipemic Drugs Flashcards

1
Q

What are the 3 types of lipoproteins?

A
  1. Very-low-density lipoprotein (VLDL)
  2. Low-density lipoprotein (LDL)
  3. High-density lipoprotein (HDL)
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2
Q

Very-low-density lipoprotein

A
  • produced by the liver

- transports endogenous lipids to the cells

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3
Q

High-density lipoprotein (HDL)

A
  • responsible for “recycling” of cholesterol

- aka “good cholesterol”

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4
Q

Low-density lipoprotein (LDL)

A

…

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5
Q

Antilipemic drugs

A
  • used to lower lipid levels

- used as an adjunct to diet therapy

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6
Q

Drug choice based on

A

the specific lipid profile of the patient

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7
Q

Name the Antilipemics

A
  • hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (aka statins)
  • bile acid sequestrants
  • Niacin (vitamin B3, nicotonic acid)
  • fibric acid derivatives (fibrates)
  • cholesterol absorption inhibitor
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8
Q

What are the most potent LDL reducers?

A
  • pravastatin
  • simvastatin
  • atorvastatin
  • fluvastatin
  • rosuvastatin
  • pitavastatin
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9
Q

Mechanism of Action for HMG-CoA Reductase Inhibitors

A
  • liver requires HMG-CoA reductase to produce cholesterol

- these drugs inhibit HMG-CoA reductase = decrease cholesterol production

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10
Q

Adverse effects of HMG-CoA Reductase Inhibitors

A
  • elevations in liver enzymes or liver disease

- myopathy (muscle pain), could lead to serious condition rhabdomyolysis

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11
Q

Interactions of HMG-CoA Reductase Inhibitors

A
  • oral anticoagulants

- drugs metabolized by CYP3A4: erythromycin, azole antifungals, verapamil, diltiazem, grapefruit juice

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12
Q

What are the bile acid sequestrant drugs?

A
  • cholestyramine
  • colestipol
  • colesevelam
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13
Q

Bile acid sequestrants are also known as

A

bile acid-binding resins and ion-exchange resins

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14
Q

What is the mechanism of action for bile acid sequestrants?

A
  • prevent resorption of bile acids from small intestine

- bile acids are necessary for absorption of cholesterol

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15
Q

What are the indications for bile acid sequestrants?

A
  • relief of pruritus associated with partial biliary obstruction (cholestyramine)
  • may be used along with statins
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16
Q

What are the adverse effects of bile acid sequestrants?

A
  • constipation

- heartburn, nausea, belching, bloating (these adverse effects tend to disappear over time)

17
Q

Niacin (Nicotinic Acid)

A
  • it is a vitamin B3.

- effective, inexpensive and often used in combination with other lipid-lowering drugs.

18
Q

When using Niacin (Nicotinic Acid),

A

much lower doses are required for its lipid-lowering effects than are more commonly given when it’s used as a vitamin.

19
Q

What is the mechanism of action for niacin?

A
  • thought to increase activity of lipase (which breaks down lipids) and inhibit lipolysis in adipose tissue
  • reduces the metabolism or catabolism of cholesterol and triglycerides
20
Q

What is an indication of niacin?

A

hyperlipidemias

21
Q

What are the adverse effects of niacin?

A
  • flushing
  • pruritus
  • GI distress
22
Q

Current fibric derivatives consist of

A

gemfibrozil (lopid) and fenofibrate (tricor)

23
Q

Fibric Acid Derivatives are also known as

A

fibrates

24
Q

What is the mechanism of action for fibric acid derivatives?

A
  • activate lipase, which breaks down cholesterol
  • suppress the release of free fatty acid from adipose tissue, inhibit synthesis of triglycerides in the liver, and increase secretion of cholesterol in the bile.
25
Q

What is an indication for fibric acid derivatives?

A

hyperlipidemia

26
Q

What are the adverse effects of fibric acid derivatives?

A
  • abdominal discomfort, diarrhea, nausea
  • blurred vision, headache
  • increased risk of gallstones
  • prolonged prothrombin time
  • liver studies may show increased enzyme levels
  • myopathy
27
Q

Cholesterol Absorption Inhibitor

A

inhibits absorption of cholesterol and related sterols from small intestine

28
Q

What are the select cholesterol absorption inhibitors?

A

ezetimibe

29
Q

Inhibition of the absorption of cholesterol and related sterols from the small intestine results in:

A
  • reduced total cholesterol, LDL, and triglyceride levels
  • increased HDL levels
  • often combined with a statin drug
30
Q

Clinical trials continue

A

currently recommended only when patients have not responded to other therapy

31
Q

Nursing Process

A

discuss the nursing process focus on patient-centered care pgs 446-449.

NURS 306 (26 decks)

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