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Pharmacology > Week 11 Lipid Lowering > Flashcards

Week 11 Lipid Lowering Flashcards

1
Q

What are used to treat hyperlipidemia

A

lipid lowering drugs

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2
Q

Bile acids are released where?

A

they are released by the gallbladder

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3
Q

Therapeutic Action: CHOLESTYRAMINE

A
  • Bind with bile salts in the intestine to form an insoluble complex that is excreted in the feces
  • results w/ the liver using excess cholesterol to make more bile acid, which lowers serum cholesterol level
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4
Q

Indications: CHOLESTYRAMINE

A
  • reduce serum cholesterol in pts w/ primary hypercholesterolemia as an adjunct to lifestyle changes
  • Treat pruritus w/ partial biliary obstruction
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5
Q

pharmacokinetics: CHOLESTYRAMINE

A
  • not absorbed systemically
  • action is limited to their effect while they are present in the intestine
  • excreted directly in the feces
  • NO METABOLISM
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6
Q

contraindications: CHOLESTYRAMINE

A
  • Allergy
  • complete biliary obstruction
  • abnormal intestinal function
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7
Q

adverse effects: CHOLESTYRAMINE

A
  • GI irritation; n/v/constipation
  • increased bleeding times r/t decreased absorption of Vit K
  • vit A & D deficiencies
  • muscle & joint pain
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8
Q

Drug-drug interaction: CHOLESTYRAMINE

A
  • interact with thiazide diuretics, digoxin, warfarin, thyroid hormones, and corticosteroids
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9
Q

nursing considerations: CHOLESTYRAMINE

A
  • GI assessment before & after given medication
  • consider giving w/ meals
  • do not give powered agents dry> always mix w/ water
  • Labs; cholesterol
  • do not crush or chew, swallow whole
  • bowel program if needs, assess bowel patterns
  • pt edu/ support
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10
Q

Therapeutic action: ATORVASTATIN

A

Blocks HMG-CoA reductase from completing the synthesis of cholesterol

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11
Q

indication: ATORVASTATIN

A
  • treatment of increased cholesterol, triglyceride, LDL levels that are unresponsive to dietary restrictions
  • prevention of CAD in adults
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12
Q

Pharmacokinetics: ATORVASTATIN

A
  • Absorbed in GI tract
  • metabolized in liver
  • excreted in feces & urine
  • most effective when taken at night
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13
Q

contraindications: ATORVASTATIN

A

Allergy
- pts w/ acute liver disease or hx of alcoholic liver disease
- pregnancy or lactation (cat X med)

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14
Q

Adverse effects: ATORVASTATIN

A

GI affects; n/v, cramps, constipation, gas
- CNS effects; dizzy, headache, blurry vision, fatigue
- possibility of rhabdomylosis

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15
Q

Drug-drug interactions: ATORVASTATIN

A

DO NOT TAKE w/ digoxin, oral contraceptives, niacin, warfarin, or grapefruit juice

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16
Q

Nursing consideration: ATORVASTATIN

A
  • Liver function labs> contraindicated w/ liver failure
  • take med at HS
  • ask if pt could be pregnant or if they are taking oral contraceptives
  • atttempt lifestyle changes first
  • check cholesterol levels
  • assess bowel elimination patterns
17
Q

HMG-CoA Reductase Inhibitor prototype drug

A

Atorvastatin

18
Q

Bile Salt Aequestraint prototype drug

A

Cholestyramine

19
Q

Another name for vitamin B

A

Niacin

20
Q

Therapeutic action: Vit B

A
  • Inhibits the release of free fatty acids from adipose tissues
  • increases the rate of triglycerid removal from plasma
  • reduces LDL and triglyceride levels, increases HDL levels
21
Q

Pharmacokinetics: Vit B

A
  • initial effect 5-7 days, max effect 3-5wks
22
Q

Adverse effects: Vit B

A

Associated w/ intense cutaneous flushing, nausea, and abdominal pain

23
Q

Drug-drug interaction: Vit B

A
  • Often combined w/ bile acid sequestrants for increased effects> give 4-6hrs after to ensure absorption
24
Q

nursing considerations: Vit B

A
  • Give at HS
  • make sure to space other meds out!
25
Q

Adverse effects: Omega 3 Fatty Acids

A
  • n/d, abdominal pain
  • May prolong bleeding time
26
Q

Contradictions: Omega 3 Acid Ethyl Ester

A

not recommended in pregnancy/ lactation

27
Q

Contradictions: Omega 3 Carboxylic Acid

A

caution in pts with allergy to fish or shellfish

28
Q

Therapeutic Action: Omega-3-Acid ethyl esters

A

inhibits liver enzyme system to decrease the synthesis of triglycerides

29
Q

Nursing Considerations for Omega 3 Fatty Acids

A
  • check s/s of bleeding
  • combine w/ appropriate diet and exercise
  • swallow whole
30
Q

Children considerations

A
  • Familial hypercholesterolemia may be seen in children
  • Lipids play an important role in developing the nervous system, so treatment is usually limited to tight dietary restrictions
  • Atorvastatin can be used in postmenarchal girls and boys 10-17 y.o.; monitor closely
31
Q

Adult considerations

A
  • Lifestyle changes should be tried before initiating any antihyperlipidemic drugs
  • HMG-CoA reductase inhibitors (statins) are the first drug of choice
  • Bile acid sequestrants are the drug of choice for women of childbearing age
32
Q

Older adult considerations

A
  • Lifestyle changes should be tried before initiating any antihyperlipidemic drugs
  • Lower doses of HMG-CoA reductase inhibitors (statins) should be used in elderly patients

Pharmacology (13 decks)

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