Cholesterol Medications Flashcards
aging, African American, hypertension, smoking, low HDL
erisks factors for high cholesterol
diabetes can all be a risk factor
diet, exercise, weight control, smoking cessation
theraputic lifesytle changes
first line of defense for high cholesterol
decrease LDL by lowering the number of LDL receptors on the liver cells
“statin” drugs
Inhibits HMG-CoA reductase which is used by the live to produce cholesterol
normal level for HDL cholesterol
over 60mg/dL
a low HDL increase the risk for art
first drug classificaiton to treat hyperlipidema
HGM-CoA Reductase Inhibitors (Statins)
Mevacor is the brand name for
lovastatin
Pravachol is the brand name for
pravastatin
Zocor is the brand name for
simvastatin
Lipitor is the brand name for
Atorvastatin
Normal lab level for triglycerides
less than 150mg/dL
150-199 borderline high, 200-499 high, over 500 is very high
normal lab value of LDL cholesterol
under 100mg/dL is optimal
LDL should be between 60mg/dL and 130mg/dL
mild GI disturbances, rash, headache, myopathy, new onset of diabetes are adverse reactions with this drug class
adverse effects of statin drugs
rhabdomyolysis
severe reaction to statins
intense mucles pain, weakness, dark urine, fever, n/v, increase in CPK, AST, ALT and lactic acid
Avoid grapefruit juice with this drug classification
statin drugs
drug to drug interactions for statins
drugs the inhibit CYP3A4, oral anticoagulations, other lipid-lowering drugs except bile-acid sequestrants
ex of CYP3A4: Amiodrane, antifungals that end in “azole”; Warfarin (monitor INR levels),
Hepatotoxicity
damage to the liver. Statin drugs can cause this issue.
get baseline hepatic function & repeat yearly, educate patient about sign/symptoms of liver failure
this statin should be taken with the evening meal or at bedtime
atorvastin (Lipitor)
one of the most common statins, all other statins can be taken at any time of the day
second drug classificaiton to treat hyperlipidema
bile acid sequestrants
this drug class prevents reabsorption of bile acids
bile acid sequestrants
bile acids are needed for the absorption of cholesterol
when taking this drug, all other medication should be taken 1 hour before or 4 to 6 hours after
bile acid sequestrants
high doses of bile sequestrant drugs decrease the absorption this types of vitamins
fat soluble vitamins (A, D, E & K)
constipation, heartburn, nausea, belching, bloating are adverse reactions with this drug class
bile acid sequestrants
cholestyramine, colesevelam and colestipol are generic drugs for this drug class
bile acid sequestrants
cholestryamine (Questran), colesevelam (Welchol) and colestipol (Colestid)
gemfibrozil (Lopid) and fenofibrate (Tricor) are this type of cholesterol lowering medicaiton
Fibric Acid Derivatives
this drug class raises the HDL level while still lowering the total cholesterol and LDL
Fibric Acid Derivatives
gemfibrozil (Lopid) and fenofibrate (Tricor)
this drug class is contradicted for patients who have severe liver or kidney disease, cirrhosis, or gallbladder disease
Fibric Acid Derivatives
gemfibrozil (Lopid) and fenofibrate (Tricor)
these drugs can cause an increase in anticoagulant effects
gemfibrozil (Lopid) and fenofibrate (Tricor)
Patients who take warfarin need to monitor their PT and INR levels closely and may need to decrease the amount of warfarin
increase risk of gallstones, headaches, prolonged PT, increase in liver enzymes, and blurry vision are adverse effects of this drug class
Fibric Acid Derivatives
gemfibrozil (Lopid) and fenofibrate (Tricor)
this drug blocks cholesterol absorption in the small intestine
ezetimibe (Zetia)
this drug has a long half life of 22 hours, so if the liver is not functioning well, the medication will remain in the system longer
this drug needs to be used with caution in patients who have liver issues
think about what patients have liver issues
ezetimibe (Zetia)
an alcoholic is a patient who should aviod this drug
these herbal products help reduce cholesterol
garlic, flax, and omega-3 fatty acids
this anticoagulation medication has potential interactions with some cholesterol lowering medications and herbal products
warfarin (Coumadin)
this herbal product has adverse effects of dermatitis, flatulence, diarrhea, vomiting, and antiplatele activity
garlic
this herbal product interacts with antidiabetic drugs and anticoagulant drugs
flax seed and flax oil
belching, a rash, and allergic reactions can occur with this herbal medication
omega-3 fatty acids (fish oil products)
jaundice
yellowing of the skin seen in patients who have liver damage
Jaudince is a late stage of liver damage, educate patients about RUQ pain, changes in color in urine and stools, edema, chronic fatigue, and loss of appetite
