Lipid Lowering Agents Flashcards
What are the Lipid Lowering Agents
HMG-CoA reductase inhibitors, Bile acid sequestrants, B vitamin niacin
What is the first line of therapy for Lipidimia?
HMG-CoA reductase inhibitors
What does “statin” stand for?
HMG-CoA reductase inhibitors
Where are statin effects mostly seen? What do they undergo?
In the liver, a marked first pass effect
Statin example medications.
Simvastatin, Atorvastatin, Rosuvastatin
Who should take statins?
people with high cholesterol, CAD, PAD, diabetes
people who had stroke, MI, TIA
What is the mechanism of action of statins?
blocks the synthesis of cholesterol
What are adverse effects of statins?
Hepatotoxicity (elevation of liver enzyme)
Myopathy (muscle pain that leads to Rhabdo)
GI upset (intermittent)
Cataracts (from CNS effects)
Rhabdomyolysis
What is Rhabdo?
breakdown of skeletal muscle fibers that release myoglobin in urine. Myoglobin makes a “coke” colored urine and show an elevated CK in labs.
What does Rhabdo lead to?
Renal failure.
What shoes nurses do/check/say to PTs on Statins?
takes 6-8 weeks to work
take w 6-8 oz of water
take at night
adherence to medication regime
avoid excessive alcohol
take contraceptions
report signs of toxicity
Labs: CK, LFT, and lipid panel
Bile Acid Sequestrant example medication
Cholestyramine, Colesevlam
Where are BAS effects mostly seen?
In the intestine
Who should take Bile Acid Seqestrants?
people with liver issues, itchiness from partial biliary obstructions, and C.diff
What is the mechanism of action of Bile Acid Seqestrants?
binds to bile acid which have high amounts of cholesterol, and release them into the stool
Cholestyramine
- how many times a day?
- do not give it if?
- is it convenient?
- should you take it while pregnant?
4-6x
constipated
difficult to mix and not tolerated well (obstruction)
NO because it decreases fat soluble vitamins that fetus/newborn need
Colesevelam
- how many x a day
- lowers the effect of?
3 tab BID or 6 tab QD
obstruction, constipation, and drug interaction
Which Bile Acid Seqestrants is preferred?
Colesevelam
Bile Acid Seqestrants adverse effects?
constipation and obstruction
decrease absorption of fat soluble vitamins
decrease drug absorption
What shoes nurses do/check/say to PTs on Bile Acid Seqestrants?
take meds 1 hour before
mix in 4-6oz for 1 minute
do not mix in juice or carbonated beverage
increase fluid intake
do not take while pregnant or lactating
