objective 2.2 (pt.3) (3) Flashcards
function as an energy source and are stored in adipose tissue
triglycerides
used to make steroid hormones, cell membranes, and bile
cholesterol
what are the 2 primary forms of lipids in the blood?
triglycerides
cholesterol
An accumulation in the blood can lead to hypercholesterolemia
low-density lipoprotein (LDL)
Also known as “good cholesterol”
Responsible for recycling of cholesterol
high-density lipoprotein (HDL)
what are the classes of drugs used to control dyslipidemia?
statins
bile acid sequestrants
nicotine acid/niacin
fibric acid derivatives
First-line therapy for hypercholesterolemia
Reduces LDL cholesterol
Decreases triglycerides
Increases in HDL cholesterol
They inhibit the HMG-CoA reductase enzyme, which is used by the liver to produce cholesterol which lowers the rate of cholesterol production
Most potent LDL reducers: atorvastatin, rosuvastatin, pravastatin, simvastatin
statins
what are the AE of statins?
Mild GI disturbances
Rash
Headache
Not for pts with elevated liver enzymes or liver disease
Myopathy (muscle pain), possibly leading to rhabomyolysis
what are the interactions of statins?
Oral anticoagulants
Drugs metabolized by CYP3A4: erythromycin, azole antifungals, verapamil hydrochloride, diltiazem hydrochloride
Grapefruit juice
Two of the most commonly used drugs in this class of cholesterol-lowering drugs
Lowers total and LDL cholesterol levels as well as triglyceride levels and raises “good” cholesterol, the HDL component
Dosed once daily, usually with the evening meal or at bedtime
atorvastatin and simvastatin
Prevent resorption of bile acids from the small intestine
Bile acids are necessary for absorption of cholesterol
May be used with statins
bile acid sequestrants
what are the AE of bile acid sequestrants?
Constipation
Heartburn, nausea, belching, bloating
Drug interactions:
**all drugs must be taken at least 1 hr before or 4-6 hrs after the admin of bile acid sequestrants
what are the considerations of bile acid sequestrants>
Overdose can cause obstruction because the bile acid sequestrants are not absorbed
Treatment of overdose includes restoring gut motility
what are the drug interactions of bile acid sequestrants?
All drugs must be taken at least 1 hr before or 4-6 hrs after the admin of bile acid sequestrants
High doses of a bile acid sequestrant decrease the absorption of fat-soluble vitamins (A,D,E, and K)
All drugs must be taken at least 1 hr before or 4-6 hrs after the admin of bile acid sequestrants
High doses of a bile acid sequestrant decrease the absorption of fat-soluble vitamins (A,D,E, and K)
nicotine acid/niacin - vit B3
Believed to work by activating lipoprotein lipase, which breaks down cholesterol
Also known as fibrates: fenofibrate, benzafibrate
fibric acid derivatives
what are the contraindications of fibric acid derivatives?
Known drug allergy
Severe liver/kidney disease
Cirrhosis
Gallbladder disease
what are the AE of fibric acid derivatives?
Abdominal discomfort, diarrhea, nausea, blurred vision, headache, increased risk of gallstones, prolonged prothrombin time, and increased enzyme levels perhaps shown by liver studies
Used as an antispasmodic, antiseptic, antibacterial, antiviral, antihypertensive, antiplatelet, and lipid reducer
AE: dermatitis, vomiting, diarrhea, anorexia, flatulence, antiplatelet activity
Possible interactions with warfarin, diazepam, and protease inhibitors
May enhance bleeding when taken with nonsteroidal anti-inflammatory drugs (NSAIDs)
garlic
Both the seed and oil of the plant are used
Uses: atherosclerosis, hypercholesterolemia, hypertriglyceridemia, gastrointestinal distress, menopausal symptoms, bladder inflammation, others
May cause diarrhea and allergic reactions
Possible interactions: antihyperglycemic drugs, anticoagulant drugs
flax
Fish oil products
Used to reduce cholesterol
May cause rash, belching, allergic reactions
Potential interactions with anticoagulant drugs
Contraindicated in pregnancy
omega-3 fatty acids
