Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > lipid lowering agents ch.47 > Flashcards

lipid lowering agents ch.47 Flashcards

1
Q

What is hyperlipidemia?

A

-Increase level of lipids (cholesterol and triglycerides) in the blood
-Total cholesterol should be (less than 200)
HDl,LDL, Triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe LDL

A

LDL – “bad cholesterol”
* Optimally want less than 100 (100-129)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe HDL

A
  • HDL – “good cholesterol”
  • Higher number means lower risk!
  • > 60 optimal (less than 40 – MAJOR risk factor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who are statin candidates?

A

Those with a history of atherosclerotic cardiovascular
disease
* Those with an LDL cholesterol level of 190 mg/dL or more
* Patients with diabetes ages 40 to 75 who do not have a
history of clinical atherosclerotic cardiovascular disease
and have an LDL cholesterol level of 70 to 189 mg/dL
* Those with a 10-year cardiovascular risk
INTRODUCTION:
HYPERLIPIDEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is cholesterol important ?

A
  • Body requires fat (esp
    cholesterol) for normal
    functioning
  • Diet
  • Produced in liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are two primary forms of lipids?

A

Triglycerides
* Function as energy source
* Stored in adipose (fat) tissue

Cholesterol
* Processed in liver
* Stored in bile, high levels
* Needed for hormone production and cell wall synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are risk factors of hyperlipidemia?

A

Elevated LDL and low HDL major risk factors for CAD
Risk factors:
Non modifiable
* age, sex, genetic

Modifiable
* lifestyle choices
* diabetes, ETOH, obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe fat metabolism?

A
  • Stomach —>Dietary fats broken
    down
  • Triggers gallbladder to release
    bile
  • Bile acid breaks down fats
  • Bile acid reabsorbed
  • Lipid lowering agents work at
    various stages of fat metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are lipid lowering agents?

A
  • HMG-CoA reductase inhibitors
    (HMGs or statins)
  • Bile acid sequestrants
  • Niacin (nicotinic acid)
  • Fibric acid derivatives
  • Cholesterol absorption inhibitor
  • Combination drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is atorvastatin(Lipitor)?

A

HMG-COA REDUCTASE INHIBITORS
(HMGS OR STATINS)

lipid lowering agent
statins are also used to assist with prevention of MI, stroke, and revascularization procedures in patients without known disease but who have multiple ASCVD risk factors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are therapeutic actions of atorvastatin?

A

Lipid lowering agent
* Inhibit HMG-CoA reductase enzyme, which is used by the liver to produce cholesterol
* Blocks the rate of cholesterol production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are pharmacokinetics of atorvastatin?

A

HMG-COA REDUCTASE INHIBITORS
(HMGS OR STATINS)

Best taken at night when liver processing most lipids
* Can take 2-3 weeks to work(peak affect)
* Avoid grapefruit juice – alters metabolism, increases toxicity
HMG-COA REDUCTASE INHIBITORS
(HMGS OR STATINS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are adverse affects of atorvastatin?

A

HMG-COA REDUCTASE INHIBITORS
(HMGS OR STATINS)
* GI –> flatulence, N/V/constipation
* CNS –> HA, blurred vision
* Monitor for rhabdomyolysis( break down of muscles with waste products that can cause acute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are contras of atorvastatin?

A

HMG-COA REDUCTASE INHIBITORS
(HMGS OR STATINS)
* Liver disease, ETOH abuse( risk of exacerbation leading to severe liver failure)
* pregnancy (X). adverse affects on fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are drug to drug interactions with atorvastatin

A

HMG-COA REDUCTASE INHIBITORS
(HMGS OR STATINS)
* Monitor patients on additional lipid lowering agents or anti-fungals for increased toxicity
* Increased risk of toxicity when used with dig/warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are bile acids?

A
  • Synthesized in liver from cholesterol; contain high levels of cholesterol
  • Released from gallbladder to break up fats into smaller units
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe bile acid sequestrates

A
  • Prevent reabsorption of bile acids from small intestine – excreted in feces, not circulated
    to liver
  • More bile acids excreted in the feces, more the liver pulls cholesterol from the blood to
    make more bile acids
  • This process lowers the amount of circulating LDL cholesterol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is cholestyramine (Questran)?

A

bile acid sequestrates
Also called ‘bile acid–binding resins’ and ‘ion-exchange resins’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is indications of cholestyramine (Questran)?

A

BILE ACID SEQUESTRANTS

-Second line tx – often used with statin
* Relief of pruritus associated with partial biliary obstruction (cholestyramine)

20
Q

What are adverse effects of cholestyramine (Questran)?

A

BILE ACID SEQUESTRANTS
* GI  N, constipation (potential fecal impaction)
* Decreased absorption of fat soluble vitamins (A, D)
* Decrease absorption of vit K (increases bleeding time)

21
Q

What are contras/cautions cholestyramine (Questran)?

A

BILE ACID SEQUESTRANTS

  • Biliary obstruction( contraindicated)
  • Abnormal intestinal function(Contraindicated)
  • Pregnancy/lactation-but if necessary may use this agent to lower cholesterol (least risky if really needed)
22
Q

What are drug to drug interactions with cholestyramine (Questran)?

A

BILE ACID SEQUESTRANTS
Decrease or delayed absorption –> warfarin, digoxin, thiazide diuretics

23
Q

What is niacin (Nicobid)?

A

Vitamin B3

Prescribed in much higher doses than found
in multi-vits
* Often given with bile acid sequestrants but
4-6 hours after

Treatment of hyperlipidemia not responding to diet and weight loss; to slow progression of ASCVD when combined with a bile acid sequestrant;

24
Q

what are therapeutic actions of niacin (Nicobid)?

A

Vitamin B3
* Inhibits release of fatty acids from adipose
tissues

Increases rate of triglyceride removal 
* Decreases LDL and triglycerides
* Increases HDL

25
Q

what are adverse effects of niacin (Nicobid)?

A

Vitamin B3
* Flushing
* GI distress (N, abd pain)
* Hyperuricemia

26
Q

what are contras of niacin (Nicobid)?

A

Vit B3
Liver disease, peptic ulcer

27
Q

what are drug to drug interactions niacin (Nicobid)?

A

vit B3
Increased myopathy if combined with HMG-
CoA reductase inhibitors

28
Q

What is gemfibrozil (Lopid)?

A

FIBRIC ACID DERIVATIVES

29
Q

What is therapeutic actions of gemfibrozil (Lopid)?

A

FIBRIC ACID DERIVATIVES
Inhibits breakdown of lipids
* Decreases production of triglycerides and
LDL

30
Q

What is adverse effects gemfibrozil (Lopid)?

A

FIBRIC ACID DERIVATIVES

  • GI  N/V
  • Muscle discomfort
  • Gallstones
31
Q

What are contras of gemfibrozil (Lopid)?

A

FIBRIC ACID DERIVATIVES

  • Liver, kidney disease
  • Gallbladder dz
32
Q

What are drug to drug interactions with gemfibrozil (Lopid)?

A

FIBRIC ACID DERIVATIVES

  • Increase in bleeding times with anticoags
  • Risk for rhabdo if combined with statin
33
Q

What is ezetimibe (Zetia)?

A

Cholesterol Absorption Inhibitors

34
Q

What are therapeutic actions of ezetimibe (Zetia)?

A

Cholesterol Absorption Inhibitors

  • Inhibits absorption of cholesterol and related
    sterols from the small intestine
  • Results in reduced total cholesterol, LDL,
    triglyceride levels
  • Also increases HDL level
35
Q

What are pharmacokinetics of. ezetimibe (Zetia)?

A

Cholesterol Absorption Inhibitors

Clinical trials ongoing to establish safety and
effectiveness with other anti-lipedemics

Metabolized in liver and small I

36
Q

What are adverse affects of ezetimibe (Zetia)?

A

Cholesterol Absorption Inhibitors

Mild abd pain, diarrhea
Muscle aches and pains

37
Q

What are contras/cautions of ezetimibe (Zetia)?

A

Cholesterol Absorption Inhibitors

If used in combo with statins, do not
continue with liver disease or in pregnancy(r/t statin)

Pregnancy as effects not well studied

38
Q

What are drug interactions with ezetimibe (Zetia)?

A

Cholesterol Absorption Inhibitors

-Bleeding when used with oral anticoags

39
Q

What are nursing considerations with lipid lowering agents for children?

A
  • Lifestyle changes first intervention
  • Use of cholesterol meds controversial
  • Statin use in some age groups
40
Q

What are nursing considerations for Lipid lowering agents for older adults?

A
  • Dietary/lifestyle changes first
    intervention
  • Statins often first drug of choice
  • Pregnancy – bile acid sequestrants
  • Dose reduce in renal dysfunction
41
Q

what to assess with lipid lowering agents?

A
  • VS, Allergies
  • Risk factors (diet, exercise, weight, etc)
  • Physical assessment (neuro, GI, skin)
  • Past medical history
  • Pregnancy status
  • Labs (serum cholesterol, lipid levels, LFTs)
42
Q

What are nursing diagnosis with lipid lowering agents?

A

Acute pain r/t GI effects
* Constipation r/t GI effects
* Risk for injury r/t potential for bleeding

43
Q

What are implementations with lipid lowering agents

A

Monitor for adverse effects
* GI, CNS, rhabdo, bleeding
* Esp when on combination therapy
-* Safety precautions

44
Q

What to educate patient with lipid lowering agents

A

Lifestyle changes (diet, smoking, exercise, etc)
* Proper medication administration
* Time of day, mixing, etc
* Labs (cholesterol levels, LFTs)

45
Q

What evaluation with lipid lowering agents?

A

Reduction in serum cholesterol levels

Pharmacology (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions