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316 > Drugs for Lowering Cholesterol > Flashcards

Drugs for Lowering Cholesterol Flashcards

1
Q

hyperlipidemia

A

high levels of lipids in the blood

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2
Q

hypercholesterolemia

A

high levels of cholesterol

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3
Q

dyslipidemia

A

abnormal levels of lipoproteins

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4
Q

Are lipid problems typically symptomatic or asymptomatic?

A

ASYMPTOMATIC!
Can cause big problems

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5
Q

triglycerides

A
  • HDL vs. LDL
  • makes up 90% of lipids in the body
  • fuels the body in times of need/energy source
  • saturated vs. unsaturated fats
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6
Q

phospholipids

A

essential to building plasma membranes

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7
Q

steroids (cholesterol)

A
  • sterol nucleus (ring structure)
  • natural and vital component of plasma membranes
  • plays a role in the development of atherosclerosis
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8
Q

cholesterol

A
  • building block for many essential biochemicals like Vitamin D, bile acids, cortisol, and sex hormones (estrogen, progesterone, testosterone)
  • essential for life
  • 75% from the body
  • 25% from diet
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9
Q

Where is cholesterol manufactured?

A

the LIVER

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10
Q

optimal level for total cholesterol

A

<200

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11
Q

optimal level for LDL cholesterol

A

<100

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12
Q

optimal level for HDL cholesterol

A

> 60

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13
Q

optimal level for serum triglycerides

A

<150

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14
Q

lifestyle changes to decrease lipid levels

A
  • diet (low fat dairy/poultry, fish/seafood and nuts, veggies, fruits, whole grains, legumes, reduce saturated fats, increase soluble fiber)
  • weight control
  • physical activity (3-4 sessions, 40 minutes)
  • stop smoking!
  • reduce alcohol consumption
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15
Q

therapeutic class of atorvastatin

A

dyslipidemic or lipid lowering medication

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16
Q

pharmacologic class of atorvastatin

A

HMG-CoA reductase inhibitor

17
Q

What does atorvastatin do?

A

it inhibits HMG-CoA reductase which is needed for the biosynthesis of cholesterol in the liver

18
Q

trade name of atorvastatin

A

Lipitor

19
Q

actions/uses of atorvastatin

A
  • decreases LDL cholesterol
  • decreases triglycerides
  • increases HDL cholesterol
  • action only occurs while taking medication, so must stay on statins for life for cholesterol reduction
20
Q

benefits of atorvastatin

A

slows progression of coronary artery disease and reduces mortality from coronary artery disease

21
Q

administration of atorvastatin

A
  • PO only (give with food to reduce GI distress)
  • GIVE AT NIGHT when liver is making cholesterol
  • pregnancy category X (teratogenic)
22
Q

side effects of atorvastatin

A
  • headache
  • GI cramping, diarrhea, and constipation
  • liver damage in small number of patients– monitor LFT’s first few months of therapy
23
Q

serious adverse effects of atorvastatin

A
  • rhabdomyolosis: can be fatal; breakdown of muscle tissue that can lead to renal failure
  • can increase digoxin levels
  • grapefruit juice inhibits metabolism of atorvastatin
24
Q

therapeutic class of cholestyramine

A

antihyperlipidemic

25
Q

pharmacologic class of cholestyramine

A

bile acid sequestrant

26
Q

administration alerts of cholestyramine

A
  • comes in a powder (take at least 60-180 mL of water and drink immediately)
  • give other drugs either 2 hours before or 4 hours after
27
Q

contraindications of cholestyramine

A
  • patients with biliary obstruction (gallbladder issues)
  • taking with food could impair absorption of nutrients and minerals
28
Q

side effects of cholestyramine

A

gas, bloating, constipation, nausea

29
Q

action of cholestyramine

A
  • binds with bile acids in an insoluble complex that is excreted in the feces
  • because of their large size, these drugs are NOT absorbed in the small intestine
  • they bound bile acids and cholesterol are eliminated in feces
  • liver responds by making more LDL receptors which reduce the level of cholesterol in the blood
  • can produce a 20% drop in LDL cholesterol
30
Q

therapeutic class of gemfibrozil

A

antihyperlipidemic

31
Q

pharmacologic class of gemfibrozil

A

fibric acid drug

32
Q

action of gemfibrozil

A
  • not well understood, but they increase the breakdown of lipoprotein lipase which increases breakdown and elimination of triglyceride rich particles from plasma
  • can reduce VLDL by 50% and increase HDLs
33
Q

cautions when taking gemfibrozil

A
  • may increase the likelihood of gallstones
  • may affect liver function– don’t use in people with hepatic impairment
  • may increase the effect of anticoagulant medications
  • increased risk of myopathy and rhadomyolysis with statins
34
Q

side effects of gemfibrozil

A

all GI: nausea, diarrhea, abdominal pain, dyspepsia

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