Drugs for Lipid Disorders

Question 1

The medication classifications include HMG-CoA reductase inhibitors also called what?

Answer 1

Statins

Question 2

What are the expected actions of the HMG-CoA reductase inhibitor?

Answer 2

1) Decreases the manufacture of LDL & VLDL cholesterol 2) Decrease triglycerides in some persons 3) Increase manufactures of HDL 4) Promotion of vasodilation

Question 3

What is the therapeutic Use for a statin?

Answer 3

Primary hypercholesterolemia

Question 4

Can you name other uses for a statin- ( HMG-CoA redctase inhibitor?

Answer 4

(Think prevention & protection)Prevention of coronary events & primary prevention in clients who have normal LDL, Protection against an MI and stroke for persons with diabetes mellitus.

Question 5

There are five (5) medications in this class think Zoo

Answer 5

Lion, Monkey, Parrot-Zoo

Question 6

Name the five medications in the HMG-CoA reductase class

Answer 6

1) atorvastatin [Lipitor] 2) lovastatin [Mevacor] 3. pravastatin [Pravachol] 4.rosuvastatin [Crestor] 5.simvastatin [Zocor]

Question 7

There are complications to taking a statin, name one.

Answer 7

Hepatotoxicity (toxic liver) evidenced by an elevated AST level (aspartate transaminase

Question 8

There is an essential action before a person is started on a statin - what is it?

Answer 8

Obtain a baseline liver function test (AST)

Question 9

True or False, Monitor liver function tests after 12 weeks and then every six months

Answer 9

True

Question 10

True or False, A statin might be discontinued if the liver function (AST) are above the expected reference range

Answer 10

True

Question 11

A nurse can observe for s & s of liver dysfunction- what are a few?

Answer 11

Anorexia, vomiting, nausea & jaundice (yellow-orange tinge color skin - whites of the eyes).

Question 12

A nurse should teach a client or patient to avoid what when taking a statin?

Answer 12

Alcohol and Grapefruit Juice (can increase the levels of statins)

Question 13

A nurse should teach a patient or client while taking a statin to report muscle aches, pain and tenderness - why?

Answer 13

If the person continues on a statin while having myopathy this can progress into myositis or rhabdomyolysis ( which is a breakdown of muscle tissue & releases a damaging protein ( myoglobin) which can damage the kidneys.

Question 14

Persons at risk for myopathy, specifically rhabdomyolysis are ?

Answer 14

Older adults, frail adults with a small body frame, and those with hypothyroidism

Question 15

This is a nursing teaching question-statins are dosed at night, why?

Answer 15

Because most cholesterol is synthesized during the night

Question 16

A nurse is teaching a patient who is starting on simvastatin (Zocor). Which of the following information should the nurse include in the patient teaching?

Answer 16

1. Take the Rx in the evening 2. Change the position slowly when moving from sitting to standing. 3. Eat a steady intake of green and leafy vegetables. 4. Avoid drinking alcohol and grapefruit juice

Question 17

You are completing an admission history for a patient who reports is taking atorvastatin [Lipitor]. Which of the following conditions or disorders is a contraindication to the reported medication?

Answer 17

1. Hx of constipation 2. Hx of HTN 3. Active hepatitis C 4. Type 2 diabetes mellitus

Question 18

There is one drug listed in Bile Acid Sequestrants can you name it?

Answer 18

cholestyramine [Questran]

Question 19

What is the expected action of Bile Acid Sequestrants (cholestyramine-Questran)?

Answer 19

Decreases LDL cholesterol

Question 20

A way to remember this drug is BARs

Answer 20

Bile Acid Sequestrants

Question 21

A Bar can be used alone or as an adjunct with a HMG-CoA inhibitor and dietary measures to reduce what?

Answer 21

cholesterol

Question 22

Teaching points about BARs about mixing the Rx- what is important?

Answer 22

Teach clients that BARs often come in powder form and must be mixed thoroughly with fluids 4-8 oz

Question 23

BARs are contraindicated in persons with what conditions?

Answer 23

persons with bowel obstructions or pancreatitis

Question 24

What is a complication of BARs?

Answer 24

Constipation

Question 25

What are some interactions of BARs?

Answer 25

BARs interfere with absorption of many Rxs. ( Levothyroxine, Glipizide, Phenytoin-( dilantin) , Fat-soluable vitamins A,D, E & K) , oral contraceptives, thiazide, diuretics, digoxin & warfarin- ttake medications that interact with BARs 1 hour before or 4 hours after.

Question 26

Patient education about BARs- name two points to teach

Answer 26

1) Increase the intake of high-fiber food 2) Increase oral fluids if not restricted

Question 27

Last, is Ezetimibe [Zetia] ( Pronounced azetimine) what is it?

Answer 27

It is a cholesterol absorption blocker

Question 28

What is the expected action for Ezetimibe [Zetia] ?

Answer 28

The Rx inhibits reabsorption of cholesterol secreted in bile and absorption of cholesterol from food (inhibits is the key)!

Question 29

Are the use, complications, contraindications are the same as BARs, and Statins Yes or No

Answer 29

Yes