Dyslipidaemia

Question 1

What is Dyslipidaemia

Answer 1

= abnormally elevated cholesterol or fats (lipids) in the blood

• increases chance of atherosclerosis and heart attacks, strokes

Question 2

What is a triglyceride

Answer 2

Glycerol molecule combined with 3 fatty acids:

- saturated (max number of hydrogen atoms 
- Monounsaturated (1 double bond so that 2 extra hydrogen could be added
- polyunsaturated (2 or more double bonds so that 4 or more hydrogen atoms 

Elevated triglyceride levels associated with increase incidence of cardiovascular events

Question 3

What is a lipoprotein?

Answer 3

• carry cholesterol throughout the body
• Very low density lipoprotein (VLDL) transports triglycerides from liver to peripheral tissues
  
  • Low density lipoprotein (LDL) cholesterol transports cholesterol to some tissues
  • High density lipoprotein (HDL) cholesterol transports cholesterol to some tissues and also transports cholesterol back from the tissues to liver where it is broken down = good

Question 4

What is LDL Cholesterol ?

Answer 4

BAD CHOLESTEROL
when elevated LDL can accumulate in blood vessel walls where it can undergo oxidation and cause 
- vessel narrowing 
- plaque formation 
- thrombus formation (clot) 
- Adverse CV events

Question 5

What is HDL cholesterol?

Answer 5

GOOD CHOLESTEROL

• transports cholesterol mostly to liver
• cholesterol transported back to liver is broken down (e.g. bile acids)
• protect against atherosclerosis and CV disease

Question 6

Role of weight loss, exercise and diet in treatment of dyslipidaemia?

Answer 6

Weight loss: every KG of exercess weight loss produces reductions in LDL and triglycerides and increases HDL

Regular exercise - increase HDL and decrease LD

Question 7

Treatment of dyslipidemia ?

Answer 7

• statins
• ezetimibe
• fibrates

Question 8

MOA of statins?

Answer 8

= inhibit HMG-CoA reductase

• increase hepatic cholesterol full blood
• decrease total cholesterol, LDL and TG
• small increase HDL concentration

Question 9

Side effects of Statins?

Answer 9

• Myopathy = disease that affects voluntary muscle control
• -> muscle pain and weakness, tenderness

Rhabodomyolysis = a breakdown of muscle tissue that releases a damaging protein into the blood

Question 10

Contradictions of statins?

Answer 10

• may not be used during pregnancy

= cholesterol is essential for foetal growth and statins cause abnormalities

Question 11

Nursing practice points of statins

Answer 11

monitor

• serum creatine kinase levels
• monitor liver function
• triglyceride levels

Question 12

Ezetimibe MOA

Answer 12

= inhibits intestinal absorption of dietary and biliary cholesterol

• decrease amount cholesterol delivered to liver

= decrease TG, decrease LDL, Decrease TC, increase HDL

Question 13

MOA of fibrates

Answer 13

decrease TG increase HDL and variable effect on LDL

Question 14

Adverse reactions of fibrates

Answer 14

• GI disturbances
• myopathy
• rhabdomyolysis

Question 15

interactions with fibrates

Answer 15

• warfarin - increase effect of blood thiners