Drugs for Lipid Disorders Flashcards
What is the most common type of lipid?
neutral fat
We need to consume cholesterol and triglycerides in the diet. T or F
False
The body makes all the cholesterol and triglycerides needed
What organ creates cholesterol?
liver
What are the lipids in the blood?
cholesterol & triglycerides
What are the functions of cholesterol?
cell membrane structure
organelle membranes
create steroid hormones
synthesize bile salts
striatum corneum of skin
How long do patients need to fast to get an accurate lipid profile?
minimum 8 hrs
recommended 10-12
What is the desirable total cholesterol?
< 200 mg/dL
What total cholesterol is borderline risk for CVD?
200-239 mg/dL
What total cholesterol is high risk for CVD?
240 mg/dL
Why is HDL considered “good” cholesterol?
Carries cholesterol to get broken down and expelled from the body
What density lipoprotein carries the most amount of cholesterol?
LDL
When would drugs be the first-line treatment for high cholesterol?
If a patient has a significantly high cholesterol level and a significant family history of high cholesterol, CVD, or MI
What is first-line treatment for high cholesterol?
Diet modification
What is atherosclerosis?
cholesterol plaque build up in arteries
What is aterosclerosis?
Arteries become stiffer and less elastic
What causes arterosclerosis?
Age & uncontrolled blood pressure
What is the prototype drug for statins?
Atorvastatin (Lipitor)
What drug is given if statins are not tolerated for hypertriglyceridemia?
gemfibrozil (Lopid)
What is the mechanism of action for atorvastatin (Lipitor)?
Decreases cholesterol production, which also leads to decrease of LDL
What does a high dose of niacin do for high cholesterol?
Decrease VLDL (main triglyceride carrier) production, therefore decreasing cholesterol
What medication can often cause a patient to still have high cholesterol?
cholesterol absorption inhibitors like ezetimibe (Zetia)
Why can taking ezetimibe still result in high cholesterol?
Less cholesterol is absorbed by the small intestines, but the body compensates by producing more cholesterol.
What is usually given with ezetimibe?
statin drug
What should the patient do if prescribed digoxin and cholestyramine?
Take cholestyramine 2 hr before or 4 hrs after digoxin
What is the main carrier of LDL?
very low-density lipoprotein
What are common SE of niacin?
Intense flushing
Hot flashes
N / D
Gas
Hepatotoxicity
Gout
What serum lipid measurement is the most accurate indicator for CVD risk?
LDL : HDL ratio
Why is the LDL : HDL ratio most important?
Some cholesterol is always transported for destruction, so the ratio is more accurate indicator for CVD risk
What time are short half-life statins taken?
at night
Why are short half-life statins taken at night?
Cholesterol is mainly produced at night
What nutrients should a client on long-term statins increase?
Fat-soluble vitamins and folic acid
What is the main modifiable lifestyle factor of concern for dyslipidemia?
High saturated fat consumption
what should patients taking statins increase consupmtion of?
coenzyme Q10?
What is a source of coenzyme Q10?
pork
sardines
beef heart
salmon
broccoli
spinach
nuts
What are common side effects of statins?
headache
abd cramping
heartburn
What are rare, serious AE of statins?
myopathy
rhabdomyolysis
What is usually used to treat hypertriglyceridemias?
fibric acid
What is commonly taken at a lower dose if the patient is also prescribed gemfibrozil (Lopid)?
warfarin
Why are periodic liver function studies done during dyslipidemia treatment?
Most drugs used to treat dyslipidemia are mainly metabolized in the liver and can lead to liver damage.
What tests should be done BEFORE hyperlipidemia medications are administered?
Get liver function studies & lipid profiles
What should be immediately reported if a patient is on a statin medication?
muscle or joint pain
A sign of myopathy or rhabdomyolysis
What is usually prescribed if the patient has a high LDL?
gemfibrozil (Lopid)
What is a contraindication of cholestyramine (Questran)?
biliary obstruction
What is a contraindication of gemfibrozil?
CKD
What is a normal cholesterol level?
< 150 mg/dL
What is cholesterol level is considered boderline high risk?
188 mg/dL
What cholesterol level range is considered high risk?
200-499 mg/dL
What is cholesterol level is considered very high risk?
500 mg/dL +
Why is LDL considered “bad” cholesterol?
Can accumulate and form plaque deposits in arteries
