hyperlipidemia Flashcards
cardiac and renal
What does LDL stand for?
Low density lipoprotein
‘bad cholesterol’
What is the optimal level for LDL cholesterol?
<100 mg/dL
What does HDL stand for?
High density lipoprotein
‘good cholesterol’
What is the minimum level for HDL cholesterol?
> 40 mg/dL or higher
What are triglycerides?
food-carbohydrates, stored unused calories and provide body with energy
What is the optimal level for triglycerides?
<150 mg/dL
Levels above this can increase heart disease risk.
What is the optimal level for total cholesterol?
<200 mg/dL
Levels below this are generally considered healthy.
How do you calculate the cholesterol ratio?
Divide total cholesterol by HDL
A higher ratio indicates a higher risk of heart disease.
What is the desirable cholesterol ratio?
<4.5:1
Ratios above this can indicate increased heart disease risk.
What is the therapeutic effect of statins?
lower levels of cholesterol and triglycerides in the blood.
MOA of statins?
Inhibit HMG-CoA reductase enzyme, stopping cholesterol production and increasing removal of LDL/triglycerides
List some common side effects of statins.
- Nausea
- Diarrhea
- Upset stomach
- Muscle pain and weakness
- Headache
- Increase liver enzymes
What is a serious adverse effect of statins?
RHABDOMYOLYSIS (generalized muscle breakdown)
Symptoms include muscle soreness, weakness, and tea-colored urine.
What nursing considerations should be taken when administering statins?
- Need liver function tests every 3-6 months (AST/ALT)
- Patients should not consume daily alcohol while taking this medication
What is Rhabdomyolysis?
breakdown of muscle fibers and release of their contents into the bloodstream.
What complications can arise from Rhabdomyolysis?
renal failure when the kidneys cannot remove waste and concentrated urine.
What are the symptoms of Rhabdomyolysis?
Symptoms include severe muscle pain (burning, cramping), muscle weakness, and dark red or brown urine.
What is the therapeutic effect of bile acid sequestrants?
They decrease LDL and increase HDL.
MOA of bile acid sequestrants?
They help the body get rid of cholesterol, decreasing LDL and increasing HDL by binding with cholesterol in the intestines, preventing absorption of fats into the blood.
What are common side effects of bile acid sequestrants?
GI upset, constipation, and increase in triglycerides.
adverse effects of bile acid sequestrants?
They decrease the ability of the body to absorb fat-soluble vitamins (A-D-E-K).
What are important nursing considerations when administering bile acid sequestrants?
Take with lots of water. Since these drugs block absorption, watch closely for vitamin abnormalities. They interact with warfarin and decrease Vitamin K, so watch INR closely.
example of a bile acid sequestrant?
Cholestyramine (Questran) powder formula.
Therapeutic effect of cholesterol absorption inhibitors?
They reduce total cholesterol and LDL.
MOA of cholesterol absorption inhibitors?
They help the body get rid of cholesterol, lowering LDL and increasing HDL by binding with cholesterol in the intestines, preventing absorption of fats into the blood.
side effects of cholesterol absorption inhibitors?
GI upset, GI discomfort, nausea, diarrhea, fatigue, joint pain.
adverse effects of cholesterol absorption inhibitors?
Reduced ability of the body to absorb fat-soluble vitamins (A-D-E-K), angioedema, swelling of the face, lips, and eyes.
How do cholesterol absorption inhibitors compare to bile acid sequestrants?
They are stronger than bile acid sequestrants.
What nursing considerations should be taken when administering cholesterol absorption inhibitors?
Monitor closely for vitamin abnormalities due to blocking absorption and watch INR closely as they interact with warfarin and reduce vitamin K.
What is an example of a cholesterol absorption inhibitor?
Ezetimibe (Zetia) in pill form.
Combine treatment: ezetimibe + simvastatin (Vytorin).
Therapeutic effect of fibrates?
reduce triglycerides and increase HDL.
MOA of fibrates?
activate lipoprotein lipase, which breaks down cholesterol from the blood and reduces cholesterol production.
side effects of fibrates?
GI upset, GI discomfort, diarrhea, nausea, muscle pain, and cholelithiasis (gallstones).
adverse effects of taking gemfibrozil with a statin?
interfere with the breakdown of the statin, causing increased levels and potential toxicity.
What nursing considerations should be taken when administering fibrates?
Patients should take the drugs 30 minutes before meals for highest efficacy. Fibrates are contraindicated in gallbladder disease and liver disease.
What are examples of fibrates?
Gemfibrozil (Lopid) and fenofibrate (Tricor) - prodrug.
What is Nicotinic acid also known as?
Vitamin B-Hyperlipidemic
What is the therapeutic effect of Nicotinic acid?
Decreases cholesterol, triglycerides, LDL, and increases HDL.
What is the mechanism of action (MOA) of Nicotinic acid?
Large doses decrease lipoprotein and triglyceride synthesis by inhibiting the release of fatty acids from adipose tissue and decreasing cholesterol production.
What are common side effects of Nicotinic acid?
Flushing, itching, nasal inflammation due to blood vessel dilation, GI symptoms, and fluid retention.
What are some adverse effects of Nicotinic acid?
Liver failure, gout, and high blood sugars.
What nursing considerations should be taken with Nicotinic acid?
Take ASA 325mg 30 minutes before dose to reduce the risk of flushing or applesauce. Take medication at bedtime.
What is an example of Nicotinic acid?
Niacin (Niaspan)
What is the purpose of antihyperlipidemic therapy?
To treat high blood lipid levels that do not decrease with lifestyle changes.
What should be checked before starting antihyperlipidemic therapy?
Patient history for liver or muscle problems and baseline blood lipid and liver function tests (LFTs).
What should be checked after starting antihyperlipidemic therapy?
Liver function tests (LFTs) and symptoms of muscle or liver damage.
What are key components of patient teaching for antihyperlipidemic therapy?
diet, exercise, weight control, follow-up lab testing (lipid profile, LFTs), and that treatment is life-long.
