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pharmacology > Week 4/Lipid > Flashcards

Week 4/Lipid Flashcards

1
Q

Take fat from the intestine to the liver

A

Chylomicrons
カイロミクロンは食物中の脂質を腸から体内のその他の場所へ輸送する

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2
Q

produced in the liver and released into the bloodstream to supply body tissues with a type of fat (triglycerides).

Gets loaded with triglycerides by the liver after the liver process the fat

Takes the triglycerides to the tissues for energy/storage

Become low density lipoproteins after dumping of triglycerides

A

Very low-density lipoproteins

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3
Q

sometimes called “bad” cholesterol, makes up most of your body’s cholesterol.

Empty lipoprotein that travels back to the liver to get reloaded with triglycerides

Get stuck in arteries – causes jams

A

Low density lipoproteins

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4
Q

Absorbs cholesterol and carries it back to the liver.
The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke

Rescue stuck LDL’s from arteries→ LDLs then return to the liver

A

High density lipoproteins

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5
Q

ASCHD (Arteriosclerotic Coronary Heart Disease):

Higher the person’s a_______, higher the chance of b______ from ASCHD

A

a) cholesterol
b) dying

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6
Q

Arteriosclerotic Coronary Heart Disease

A

Damage or disease in the heart’s major blood vessels.
The usual cause is the buildup of plaque. This causes coronary arteries to narrow, limiting blood flow to the heart.

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7
Q

Lipoprotein composed of?

A

cholesterol
phospholipids
triglyceride　
lipoprotein　

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8
Q

Eat food →Fat goes to stomach→
a) ＿＿＿→ liver

A

a) Chylomicrons

Fat goes to the liver
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9
Q

What is triglyceride?

A

They come from food
Triglycerides are a type of fat (lipid) found in your blood.
When you eat, your body converts any calories it doesn’t need to use right away into triglyceride

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10
Q

Liver process the fat to deliver
a)______ into VLDLS → taken to the b)_______ as source of energy

A

a) triglycerides
b) tissue

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11
Q

After fat removed become LDLS, LDLs get stuck in ?

A

Arteries

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12
Q

HDLs can carry out LDLs to where?

A

Liver
LDL go back to liver

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13
Q

Too many LDLs or not enough HDLs to rescue , then what disease will occur?

A

Atherosclerosis (the buildup of fats)
Thrombi can become unattached from buildup and become embolism causing:

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14
Q

What is density?

A

How many phospholipids and proteins are present
Phospholipids, are a class of lipids whose molecule has a hydrophilic “head”

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15
Q

a) Bile is what?
b) Made by where?
c) Store in where?
d) Bile help with what?

A

a) digestive juice
b) liver
c) gallbladder
d) small intestine help to absorb fat

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16
Q

What bile acid made of?

A

Cholesterol
97% are reused

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17
Q

Is bile and bile acid the same?

A

Bile contains bile acids, which are critical for digestion and absorption of fats

18
Q

Bile Acid Resins
Name of meds?

A

Cholestyramine
Colestipol
Colesevelam

Cole: all drugs start with “cole”

19
Q

Bile Acid Resins/BARs
Dosage form

A

Powder (most common)
Chewable bars
Tablets

powder form is grainy, tastes better cold & mixed with pulpy beverage - don’t mix w/ carbonated beverage

20
Q

Bile Acid Reins
ADRs

A

GI constipation,
bloating
epigastric fullness
nausea
flatulence

21
Q

Bile Acid Reins
Nursing Notes

A

Inc pt fluid intake, bulk in diet
Use stool softeners
Start w/ small dose & titrate up
40% pts discontinue w/in a year d/t ADRs
Interacts w/ drugs & fat soluble vitamin (A,D,E,K)

4 hours separating with other drugs

22
Q

Bile Acid Resins
Action

A

Binds to bile acids to stop their reuse

Result: body must make more bile acids from cholesterol in LDLs → dec LDLs (-25%)

23
Q

Niacin
a) dosage form
b) Advantage and Disadvantage

A

a) Immediate release (IR): 4g
Sustained release (XR): 2g

b) IR has immediate action and is reason for symptomatic ADRs
XR causes liver toxicity

24
Q

Niacin
ADRs IR and XR

A

IR: flushing, itching, rash, hives
cause dilation of blood vassals
(Niacin is not nice on skin)

XR: liver toxicity, GI bleeds, hyperglycemia/diabetes, gout, muscle damage

25
Q

Niacin
Action

A

Dec liver production of VLDLs
Result: dec LDLs

26
Q

Niacin
Prevention symptoms

A

Start with small dosage
Take with food
Use the XR dosage form
Take 325mg aspirin before each dose
avoid administration with hot fluids and alcohol

27
Q

Niacin is best drug for?

A

HDL!
3000mg HDL +20% LDL -20%
4500mg HDL +25% LDL -25%

28
Q

-statin
ADRs

A

Headache
GI intolerance
Myalgia
Flu symptoms
Hepatotoxicity
Myopathy
Rhabdomyolysis

29
Q

What is the most benefit group to take statin?

A

atherosclerotic cardiovascular disease
ASCVD
>21 yrs age w/ LDL > 190
40-75 yr old diabetics (LDL 70-189)
40-75 yr old nondiabetics (LDL 70-189) w/ ASCVD risk of 7.5%+

30
Q

What is the myopathy and who is risk for?

A

Weakness, soreness, aches with upper limit normal
Higher statin dose
Pt with renal impairment
Statin + fiber

31
Q

Statin is good for?

A

Lower LDLs!!
10mg -39%
20mg -43%
40mg -50%
80mg -60%

32
Q

PCSK9 Inhibitors
Action

A

Stops PCSK from binding to LDLs and preventing their reuse
Result: LDLs don’t get stuck in bloodstream

33
Q

PCSK9 Inhibitors
a) dosage
b) ADRs

A

a) SQ injection every 2-4 weeks
b) EXPENSIVE
Well tolerance
Muscle aches, Rash

Use in pts w/:
Statins aren’t working
Naturally produces high LDLs

33
Q

Ezetimibe
a) action
b) use with which drug
c) ADRs

A

a) Inhibits cholesterol absorption
b) Used with Statins to further reduce LDLs by 15-20%
c) None different from placebo

34
Q

Fibric Acids
a) action
b) name

A

a) Used for TRIGLYCERIDE lowering
Inc activity of lipoprotein lapase → inc breakdown of VLDLs & chylomicrons

b) Gemfibrozil
Fenofibrate

35
Q

Fibric Acids
Nurse note

A

Dyspepsia
Abdominal pain
Myopathy
Do NOT use w/ statins → can cause inc risk for myopathy

36
Q

Omega-3 Fatty Acids
a) action
b)

A

a) Used for TRIGLYCERIDE lowering
-45%
b) Well tolerated
Eructation
Flu symptoms
Dyspepsia
Change in taste sensation

37
Q

Omega-3 Fatty Acids
Nurse note

A

Used for pts w/ hypertriglyceridemia
Can cause hepatic impairment
May inc LDLs
Do not use in pts w/ seafood allergy

38
Q

What is Myalgia?

A

muscle pain w/out muscle destruction – more common than myopathy – no CK blood level changes

39
Q

What is Myopathy?

A

destruction of muscle cells – pt has CK greater than 10 xs the normal upper limit
More common in pt w/ higher statin doses, renal impairment, statin + fibrate drug combination
Can lead to rhabdomyolysis

40
Q

Rhabdomyolysis?

A

organ shut down d/t inc CK levels in the blood

41
Q

a) Eructation?
b) Urticaria?

A

a) burping
b) hives

pharmacology (34 decks)

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