CV - anti-lipemic agents Flashcards
lifestyle stuff
- omega 3, 6 fish oil
- psyllium fiber w h2o
- niacin vit B3
- –ae of skin flusing or itching - may decr dose
- –incr blood glucose so no DM2
total cholesterol range
LDL + HDL
<200mg/dL
LDL <100
HDL >40
triglyceride range
<150
4 categories of anti-lipemic agents
1 HMG-CoA reductase inhibitor
2 bile acid sequestrants
3 cholesterol absorption inhibitor
4 fibrates
HMG-CoA reductase
drug names
1 atorvastin
2 simvastin
3 rosuvastin
statin drugs, number 1 drug in the world
HMG-CoA reductase
statin drugs
MOA
- decr manufacture of LDL, VLDL
- incr HDL
- stops sat fats fr being broken down into cholesterol
HMG-CoA reductase
statin drugs
Tx
- hypercholesterolemia
- prevent coronary events
- protects against MI
HMG-CoA reductase
statin drugs
AE
- hepatotoxicity
- myopathy
- rhabdomyolysis
HMG-CoA reductase
statin drugs
CI
cat X
HMG-CoA reductase
statin drugs
RN/teaching
- monitor LFT after 12wk + Q6mo
- monitor creatinine kinase [CK]
- monitor + report muscle pain
- use contraceptives
- take pill in evening
- avoid grapefruit
- avoid ETOH
asian clients should avoid which statin?
rosuvastatin
take statin drugs in the evening bc
that is when most cholesterol is synth
with statin, you should monitor…
LFT: AST + ALT
CK
muscle pain
bile is made in the ____ from ____ stored in ______
liver
cholesterol
gallbladder
common drugs that are added w statins
ezetimibe + bile acid sequestrants
Bile-Acid Sequestrants
drug names
colesevelam, colestipol, cholestyramine
colesevelam, colestipol, cholestyramine [bile-acid-seq]
MOA
reduce cholesterol especially LDL
colesevelam, colestipol, cholestyramine [bile-acid-seq]
Tx
- *DM2 - lowers blood gluc
- BILE DUCT DISEASE - decr bile in partial biliary obstruction
colesevelam, colestipol, cholestyramine [bile-acid-seq]
A/E
- constipation/gas
- decr absorption of fat soluble vits ADEK
colesevelam, colestipol, cholestyramine [bile-acid-seq]
CI
- use contraception but NOT ORAL contraceptives
- bowel obstruction
colesevelam, colestipol, cholestyramine [bile-acid-seq]
- interferes w many other drugs
- take 1 hr before or 4 hr after other drugs
- not systemically absorbed
- incr high fiber
- incr oral fluid
- take med w food or 8oz h2o
bile-acid-seq is commonly used w _____
statin
fibrate
drug names
gemfibrozil
fenofibrate
gemfibrozil, fenofibrate
MOA
- decr triglyceride levels
- incr HDL levels
gemfibrozil, fenofibrate
A/E
gallstone
myopathy
hepatotoxicity
—-anorexia, NV, jaundice
gemfibrozil, fenofibrate
CI
- Hx liver problems
- gallbladder disease
gemfibrozil, fenofibrate
RN/teaching
monitor ability to eat fried foods
-can cause bloating + upset stomach
if pt taking gemfibrozil or fenofibrate
gets bloated + upset stomach fr eating fried foods, then this indicates…
gallbladder problems
do not give ____ with statins
fibrates
statins increase the risk of myopathy
cholesterol absorption inhibitor
drug name
ezetimibe
ezetimibe [cholesterol absorption inhibitor]
MOA
limits reabsorption of cholesterol secreted in bile
+ absorption of cholesterol fr food
ezetimibe [cholesterol absorption inhibitor]
Tx
med used alone or in combo w statin
ezetimibe [cholesterol absorption inhibitor]
A/E
hepatitis
myopathy
ezetimibe [cholesterol absorption inhibitor]
CI
pre-existing liver disorders
ezetimibe [cholesterol absorption inhibitor]
rn/TEACHING
LFT, CK
start exercising
