Dyslipdemia Meds: Others-MJ

Question 1

What are the 5 other drugs that can be taken for dyslipidemia?

Answer 1

Niacin
Bile-Acid sequestrates
Ezttimibe
Fibrates
Fish Oil

Question 2

Niacin (nicotinic acid, Vit. B3)

What does niacin do to our lipoproteins and triglycerides?

Answer 2

Increases HDL
Decreases LDL
Decreases triglycerides

Question 3

What are the 4 adverse effects of niacin?

Answer 3

• Intense flushing, itching
• GI upset
• Increases uric acid
• Hepatoxicity (rare)

Question 4

If someone is taking niacin and keeps experiencing the adverse effect of intense flushing, what can we tell them to do?

Answer 4

Take aspirin 30 minutes before taking niacin

Question 5

Because bile is made out of cholesterol, the bile acid sequestrates keep the bile in the GI tract to prevent ____ and promote ___

Answer 5

Prevent absorption and promote excretion

Question 6

What is the name of the drug that is a bile acid sequestrate?

Answer 6

Cholesevelam

Question 7

What does cholesevelam do to our lipoproteins and triglycerides?

Answer 7

Lowers LDL
Increases triglycerides (bad!)

Question 8

What side effects may your patient experience if taking cholesevelam?

Answer 8

Mild GI side effects (nausea, bloating)

Question 9

Why can cholesevelam bind with other drugs? What does this mean to us as nurses?

Answer 9

It can bind to other drugs because its a sticky substance; it may interfere with the absorption of other drugs so we need to avoid mixing with other meds

Question 10

If a patient is experiencing constipation, what can we teach them?

Answer 10

Increase their fiber and fluids

Question 11

If our patient takes the powder form of cholesevelam, what should we teach them?

Answer 11

These bile acid squestrants are not lipid soluble, so when you mix your powder form with a liquid, it will appear cloudy and not clear

Question 12

If our patient is taking several other meds along with cholesevelam, what should we teach them?

Answer 12

Take cholesevelam 1 hour before other meds or 4 hours after other meds

Question 13

What is the MOA of ezemtimibe?

Answer 13

Acts on the cells of the small intestine to inhibit dietary cholesterol absorption; inhibits reabsorption of cholesterol secreted in the bile

Question 14

What does ezemtimibe do to our lipoproteins?

Answer 14

Lowers LDL

Question 15

Ezemtimibe adverse effects are similar to _____.

Answer 15

Statins

Question 16

Does ezemtimibe cause GI issues? Do we need to take these drugs with food?

Answer 16

No; can be taken with or without food

Question 17

Can we combine ezemtimibe with a statin?

Can we combine ezemtimibe with bile-acid sequestrate?

Answer 17

You can combine exemtimibe with a statin, although it may increase risk of hepatoxicity and rhabdo. Can be taken at the same time

Yes, you can be taking both ezemtimibe with bile-acid but would need to take ezemtimibe 2 hours before the bile-acid or 4 hours after

Question 18

What is the MOA of fibrates?

Answer 18

Activates PPAR alpha receptors which increases the breakdown of fatty acids

Question 19

What do fibrates do to our triglycerides?

Answer 19

Lowers triglycerides

Question 20

What are the most common adverse effects seen with fibrates?

Answer 20

Rash (very common) and GI disturbances (N/V, diarrhea)

Question 21

What are the two drugs that are fibrates?

Answer 21

Fenofibrate

Gemifibrozil

Question 22

Taking gemifibrozil (fibrate) may increase _______ in a patient

Answer 22

Gallstone formation

Question 23

Fibrates may also cause _____.

Answer 23

Myopathy

Question 24

When should we tell our patient to take gemifibrozil?

Answer 24

30 minutes prior to morning and evening meals

Question 25

What do fibrates interact with? Why is this important for client education?

Answer 25

Interacts with warfarin. We need to know if our patient is on this drug, because BOTH fibrates and warfarin is highly protein bound! Levels would need to be checked

Question 26

Fish oil: Do recent studies reveal consuming fish oil has high advantage in preventing heart disease in high-risk populations?

Answer 26

No; the studies reveal that it provides no advantage in prevention of heart disease in high risk population

Question 27

What does fish oil do to our lipoprotein and triglycerides?

Answer 27

Increases LDL

Lowers triglycerides

Question 28

What should we do with our fish oil to prevent fish burps?

Answer 28

Refrigerate it

Question 29

Fish oil reduces _______

Answer 29

Platelet aggregration

Question 30

What does more work for a surrogate endpoint (LDL, HDL, triglycerides): Statin or non-statin

Answer 30

Non-statins

Question 31

What does more work for a clinical endpoint (Number of MI, strokes, etc): Statin or nonstatin?

Answer 31

Statin