Dyslipidemia Meds Flashcards
Dyslipidemia
Abnormally elevated cholesterol or fat in the blood
How do Statins work?
They inhibit HMG-CoA reductase so mevalonate isnt formed, therefore Cholesterol CANNOT be made (DOC for Decreasing LDL)
Statins cause ________ in LDL, ________ HDL, ________ in vLDL
decreases, increases, decreases
Niacin (Nicotinic acid or vitamin b) causes a _____ in HDL, ________ in LDL, _______ in trigylcerides
Increase HDL, Decrease LDL, Decrease triglycerides
How doe Bile-acid Sequestrants work?
Bile is made from cholesterol. This drug keeps bile in the GI tract to prevent absorption and promote excretion.
Bile-acid Sequestrants will ______ LDL cholesterol levels and _______ triglycerides
Reduce LDL cholesterol levels, INCREASE triglycerides (bad)
How does Ezemtimibe work?
Ezemtimibe acts on cells of the small intestine to inhibit dietary cholesterol absorption.
Ezemtimibe _______LDL
decreases LDL
How do Fibrates work?
Activates PPAR alpha receptors which increase breakdown of fatty acids
Fibrates _______ triglycerides
Decrease triglycerides
Your patient has a history of non-alcoholic fatty liver disease. They also have high cholesterol. The doctor prescribed Pravastatin. Should the nurse administer the drug?
Yes, but take caution
A pregnant woman is prescribed Atorvastatin (LIPITOR) what should the nurse do?
Hold the med and call the doctor. Pregnancy risk X
Your patient has a history of viral and alcoholic hepatitis and is prescribed Rosuvastatin. What should the nurse do and why?
Hold the med and call the doctor. Contraindicated
Any side effects for Rosuvastatin?
Doesn’t work well with people from asia, causes Rhabdo (breakdown of muscle tissue that releases a damaging protein into the blood.)
What are the Pleiotropic effects of Statins?
- Stabilizes arterial pressure
- anti-inflammatory properties
- Anti-oxidant properties
- Anti-platelet/thrombotic properties
Adverse effects of Statins?
Muscle pain (myopathy)
Hepatotoxicity ( AST ALT tests)
CYP interactions
Pregnancy risk X
What should the nurse teach the client about taking Statins?
- The drug will take ~2 weeks to work
- We will take this in the evening when your body produces cholesterol
- report unexplained muscle pain
- will not replace diet and exercise.
What percentage of clients develop myopathy?
5-10%
Can progress to rhabdomyolysis so really Monitor CK levels. Hold statins if CK > 10x the upper limit of normal
What percentage of clients develop Hepatoxicity?
0.5-2%
Obtain baseline LFTs and if they have liver disease call the doctor but don’t call if its
nonalcoholic fatty liver disease
Niacin (Nicotinic Acid or Vitamin B3) signs and symptoms of adverse effects?
*flushing- Take aspirin 30 min before to help
*GI upset- Take with meals
*Increased Uric Acid
Hepatotoxicity (rare)
*Must control lipid levels through diet- may need dietary counseling
Patient has gout and is taking 5 hour energy. What should the nurse do and why?
Tell them to stop. It can increase Uric acid because it contains Niacin.
Bile-Acid Squestrants signs and symptoms of adverse effects?
- Mild GI side effects (nausea, bloating)
- Can bind with other drugs (b/c sticky substance—may interfere with absorption of other drugs)
Cholesevelam
Bile-Acid Squestrant ↓LDL • Can increase triglycerides (bad) • No absorption into blood • Only mild GI side effects (nausea) • Can bind with other drugs
Ezetimibe signs and symptoms of adverse effects?
- DOES NOT CAUSE GI issues
- Wouldn’t want to combine with a Statin b/c of increase risk of hepatotoxicity or Rhabdomyolysis
