hyperlipedemia Flashcards
Goal with treatment
reduce blood clots, stroke, heart attack.
Triglycerides
Fat storage, most common, energy
phospholipids
Help make plasma proteins.
Lesothins- best known in soy beans and egg yokes
Steroids
Cholesterol component of cell membrane produced by the liver found in foods that we eat.
most well-known for contributing to atherosclerosis and heart disease
helps build vit d, estrogen. and testosterone.
Lipoproteins
Help transport cholesterol, triglycerides, and phospholipids they are classified by composition, size, weight, and density.
3 phospholipids
HDL-made mostly of protein
LDL-Made mostly of cholesterol
VLDL-very low made mostly of triglycerides.
HDL
made?
What do they do?
increased levels mean?
Made in liver and in sm intestine.
Decreases level of cholesterol by transporting to liver for destruction and removal in feces
increased levels reduce risk of heart disease
LDL rich in? Work by? stored? cause?
Very rich in Cholesterol
It increases cholesterol by transporting to tissues and organs from liver
Stored in lining of blood vessels and cause plaque and atherosclerosis
VLDL
Rich in triglycerides ( some cholesterol)
Deliver triglycerides to storage in the adipose tissue.
might contribute to atherosclerosis.
Lipid profile
Total cholesterol- less than 200mg/dl
LDLs-less than 100mg/dL
HDL- greater than 60mg/dL
Triglycerides- less than 150mg/dL
Atrovastatin (Lipitor)
Most effective for lowering LDL
Few adverse effects
PO
Generally given to people with genetic.
Statins
Interfere with HMG-CoA reductase, the critical enzyme in the biosynthesis of cholesterol
Bile acid sequestrates
Bind bile acids, thus increasing the excretion of cholesterol in the stool
Lipitor MA
Inhibits HMG CoA reductase which then regulates the production of cholesterol. They also increase LDL receptors on the liver and so LDLs are removed from the blood.
Lipitor AE
Gi discomfort, myopathy/Rhabdomyolsis-breakdown of mm fibers spill into blood circulation.
Teratogenic effects/birth defects-category X
Hepatotoxicity
Grapefruit juice increases levels.
Nursing for atorvastatin
Check LFTs
lipid profile
Evaluate GI
Lifelong therapy unless lifestyle changes
Bile Acid sequestrates
MA
Cholestyramine (Questan)
Binds to bile acids in the intestines, forming and insoluble complex that contains cholesterol.
Prevents reabsorption of bile acids eliminated in the feces.
Liver makes more receptors- reducing LDL levels in the blood.
Adverse effects of Cholestyramine (Questan)
GI stuff-pooping and gas -Interfere with absorption of other nutrients
contraindications for Cholestyramine (Questan)
Patients with gallbladder obstruction.
Someone with high
serum triglyceride or greater than 400
or for someone with GI disorders.
Nursing for cholestyramine
comes in powder form must be mixed with water/non carbonated beverage
Mixed well and swallowed immediately
give other meds 1 hr before or 4 hours after.
Fabric acid drugsMechanism of action
gemfibrozil (Lopid)
Activate the enzyme lipoprotein lipase-increases the breakdown and elimintaion of triglycerides from the plasma
Inhibits breakdown of fat
most effective for treating triglycerides-little effect on LDL
Usually combined with statins to work more efficiently.
gemfibrozil (Lopid) AE
GI pain, .dyspepsia, diarrhea, abd pain. N/V
Can worsen gallbladder disease and liver impairment.
hispanics and native americans have a higher chance of gallbladder disease.
Nursing for gemfibrozil
Monitor for myopathy/rhabdomyolysis,
monitor LFT’s
Take med with food to help with GI
Goals for hyperlipodemia
Diet, weight, exercise, no smoking.
