Triglycerides part 2

Question 1

Long term use of niacin causes acanthosis nigricans: darkening of the skin

Question 2

Niacin can cause flushing

Prevention: ASA 325mg 30 minutes prior

Take w/______
Take at _______
Titrate dose slowly
or Don’t use niacin unless someones has really high triglycerides because thats the only thing it can treat

Answer 2

food

bedtime

Question 3

• Angel is a 52 year old Mexican-American man with type 2 diabetes who has been out of his medication, including insulin for 6 months.He works nights and a diet high in saturated fat and carbs. He does not smoke, but he drinks socially. He states he was not on medication for his BP.
  BP 134/88
  TC 310mg/dL
  dLDL 164mg/dL
  TRIG 780mg/dL
  HDL 44mg/dL
  BUN 20
  Glu 480
  K 4.3
  Co 18
  SCr 1.0
  Na130
  Cl104
  Ca 8.1
  PO4 3.0
  Alb 3.5
  AST 42
  ALT 40

ASCVD is 16.8%
No meds for blood pressure so pt needs high intensity statin even if he pt didn’t have diabetes you still have to go to _____________ but constantly monitor his liver function so atorvastatin is a good choice or rosuvastatin is fine
LDL is 160
Triglycerides are 780

Get pt back on insulin which will help sugars when sugars are high triglycerides are high so we have to get pt eating a little healthier, incorporate more _________and nuts and fewer ____________ and carbs, decease his alcohol intake…if high intensity statin won’t control him to less than 500 then add a _____ in addition to the statin

Answer 3

high intensity statin

fish

fewer saturated fats

lovaza

Question 4

If pt has good LDL but still have a lot of cardiovascular events so measure ___________ and generally this is genetic and doesn’t have to do with pts lifestyle…LP(a) increases plaques and when its high in the system it causes aortic stiffening, MI, and stroke, increase clotting

Answer 4

Lp(a)