Antilipemic Drugs Flashcards

Question

Bile Acid Sequestrants: (bile acid-binding resins/ ion-exchange resins) Mechanism of Action? Bile acids are necessary for? The more the bile acids are excreted, the more the liver converts? Commonly used as?

Answer 1

Bind bile and prevent the resorption of bile acids from small intestine (bile acids are necessary for the absorption of cholesterol from the SI and are synthesized from cholesterol in the liver; the natural way the liver excretes cholesterol from the body). The more bile acids are excreted in the feces, the more the liver converts cholesterol to bile acids. This reduces the level of cholesterol in the liver and the circulation. LDL is released to compensate and it bind to receptors and is taken up by the liver- reducing circulating LDL in the blood Lower cholesterol, (esp. LDL-C) by increasing the destruction of LDL Bile acids are necessary for absorption of cholesterol. The more the bile acids are excreted, the more the liver converts cholesterol to bile acids, reducing cholesterol in liver and circulation Commonly used as an adjunct to statin therapy

Answer 2

Type II hyperlipoproteinemia Relief of pruritus associated with partial biliary obstruction (cholestyramine) May be used along with statins

Answer 3

Constipation Heartburn, nausea, belching, bloating ---These adverse effects tend to disappear over time. ----Increasing dietary fibre intake or taking a fibre supplement such as psyllium (Metamucil® and others), as well as increasing fluid intake, may relieve constipation and bloating. ----May also cause mild increases in triglyceride levels

Answer 4

Overdose can cause obstruction because the bile acid sequestrants are not absorbed. Treatment of overdose includes restoring gut motility. Take other drugs at least 1 hr before or 4-6 hrs after bile sequestrants

Answer 5

All drugs must be taken at least 1 hour before or 4 to 6 hours after the administration of bile acid sequestrants. High doses of a bile acid sequestrant decrease the absorption of fat-soluble vitamins (A, D, E, and K).

Answer 6

Contraindications: known hypersensitivity, phenylketonuria or complete biliary obstruction Pregnancy and lactation considerations Treatment of loose bowel movements Caution when administering dry powder interfere with the distribution of fat soluble vitamins used for constipating effect, given for loose BMs

Answer 7

Vitamin B3

Answer 8

Lipid-lowering properties require much higher doses than when used as a vitamin. Effective, inexpensive, often used in combination with other lipid-lowering drugs Often given as adjunct to statins

Answer 9

inhibit lipolysis in adipose tissue decrease esterification of triglycerides in the liver increase the activity of lipoprotein lipase Reduces the metabolism or catabolism of cholesterol and triglycerides Resultant effect: decreased triglyceride levels, decreased LDL and increased HDL levels May also stimulate fibrinolytic system to break down fibrin clots

Answer 10

Effective in lowering triglyceride, total serum cholesterol, apolipoprotein B and LDL cholesterol levels Increases HDL levels Therapeutic effects noticed after 1-4 days of therapy Maximum effects in 3-5 weeks of continuous therapy

Answer 11

Contraindicated in peptic ulcer disease, hypertension, active hemorrhagic process liver disease, allergy

Answer 12

Flushing (caused by histamine release) Pruritus Gastrointestinal distress start on low dosage, take with meals small dose of aspirin (NSAID) may be taken 30 minutes before nicotinic acid to minimize cutaneous flushing contra- statins- increase risk for myopathy, allergy, peptic ulcer, liver disease, hemorrhage, hypotension, lactating women, gout

Answer 13

Also known as fibrates gemfibrozil- decreases synthesis of Apo-B and lowers the VLDL level, increase HDL level, lower plasma triglyceride levels Other: bezafibrate fenofibrate

Answer 14

Activates lipoprotein lipase, which breaks down cholesterol Suppress the release of free fatty acid from adipose tissue Inhibit the synthesis of triglycerides in the liver Increase the secretion of cholesterol in bile can induce changes in blood coagulation; decrease in platelet adhesion (can increase plasma fibrinolysis the process that causes fibrin (clots) to be broken down decrease triglyceride levels and increase HDL levels; treats dyslipidemia

Answer 15

Treatment of types III, IV, and V hyperlipidemias The fibric acid derivatives bezafibrate, gemfibrozil, and fenofibrate decrease the triglyceride level and increase the HDL cholesterol level by as much as 25%.

Answer 16

Known drug allergy Severe liver or kidney disease Cirrhosis Gallbladder disease use birth control- childbearing year and d/c in pregnant women

Answer 17

Abdominal discomfort, diarrhea, nausea Blurred vision, headache Increased risk of gallstones Prolonged prothrombin time Increased enzyme levels perhaps shown by liver studies

Answer 18

Gemfibrozil enhances the action of oral anticoagulants (warfarin) All are given with a statin, which increases risk of myositis, myalgia, and rhabdomyolysis.

Answer 19

Decreased hemoglobin level, hematocrit value, and white blood cell count Increased aspartate aminotransferase, activated clotting time, lactate dehydrogenase level, and bilirubin level

Answer 20

ezetimibe (Ezetrol)

Answer 21

Selectively inhibits absorption of cholesterol and related sterols from the small intestine Results in reduced total cholesterol, LDL cholesterol, apolipoprotein B, and triglyceride levels Also increases HDL cholesterol levels Often combined with a statin drug Can be used as monotherapy Levels are increased by fibric acid derivatives- concurrent use is not recommended contra- allergy, active liver disease

Answer 22

Used as an antispasmodic, antiseptic, antibacterial, antiviral, antihypertensive, antiplatelet, and lipid reducer Adverse effects: 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)

Answer 23

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

Answer 24

Fish oil products Used to reduce cholesterol May cause rash, belching, allergic reactions Potential interactions with anticoagulant drugs Contraindicated in pregnancy

Answer 25

Before beginning therapy, obtain a thorough health and medication history. Assess dietary patterns, exercise level, weight, height, vital signs, tobacco and alcohol use, and family history. Assess for contraindications, conditions that require cautious use, and drug interactions. Obtain results of baseline liver function studies. Refer to guidelines regarding administration times and meals. Counsel patient concerning diet and nutrition on an ongoing basis. Instruct patient on proper procedure for taking the medications. Provide teaching regarding the use of NSAIDs and aspirin. Inform patients that these medications may take several weeks to show effectiveness. Instruct patients to report persistent gastrointestinal upset, constipation, abnormal or unusual bleeding, and yellow discoloration of the skin. Monitor for adverse effects, including increased liver enzyme studies. Monitor for therapeutic effects. Reduced cholesterol and triglyceride levels

Answer 26

Contraindications include biliary obstruction, liver dysfunction, and active liver dysfunction Patients on long-term therapy may need supplemental fat-soluble vitamins (A, D, E, K). Powder forms must be taken with a liquid, mixed thoroughly but not stirred, and never taken dry. Other medications should be taken 1 hour before or 4 to 6 hours after meals to avoid interference with absorption. To minimize adverse effects of niacin, start on a low initial dose and gradually increase it, and have the patient take the medication with meals. Small doses of aspirin or NSAIDs may be taken 30 minutes before niacin to minimize cutaneous flushing.

Answer 27

a fat-soluble steroid alcohol, widely distributed in the body (bile, blood, brain tissue, liver, kidneys, adrenal gland, myelin sheath) carry fat to tissues, primarily in the liver cholesterol-lowering drugs, act by inhibiting the rate-limiting step in cholesterol synthesis (statins) conjugated protein synthesized in the liver that contains varying amounts of triglycerides, cholesterol, and other lipids consist of fatty acids and a type of alcohol known as glycerol

Answer 28

atherosclerotic plaque which leads to CAD lesion of atherosclerosis repeated; injury to artery wall such as smoking, elevated BP, diabetes, elevated cholesterol. Ongoing inflammatory response has a central role in the formation of plaque referred to as atherogenesis. Liver

Answer 29

males 40 years or older females 50 years or older or postmenopausal family history, premature CAD cigarette smoking BP 140/90 low HDL diabetes

Answer 30

Cholestyramine- test for PKU; pts with PKU cannot process amino acid phenylalanine (a protein component). High levels result in behavioural, cognitive, and learning dysfunction (child). for adults to monitor PKU monthly (dissolve it for 1 minute). Give 1 hour before or 4-6 hrs after other meds. Take with meals statins- not for pts with liver disease, who drink alcohol because of potential liver dysfunction- assess liver tests. Take with 120-180 mL of water or with meals. Monitor liver and kidney function every 3-6 months. nicotinic- contra in active bleeding. flushing of face may occur, take the drug with meals. Monitor liver, kidney , and PThrombin. Take with meals. antilipemic- may require supplementation of vitamins, GI problems, and liver dysfunction. low fat, low cholesterol diet (diet rich in raw veggies, fruit, and bran) Incase fluids.

Answer 31

powder/ granule , oral-based form of antilipemic- must be mixed with carbonated liquids

Answer 32

participate in the formation of A plaque which leads to CAD when plaque forms in the BVs that supply the heart with oxygen and nutrients, the lumen will decrease and 02 and nutrients supplied will also be reduced

Answer 33

administer a small dose of aspirin or an NSAID 30 minutes before niacin dose cutaneous flushing statins liver cirrhosis fibric acid derivatives take with meals, take fibre supplements, increase fluids, not take with other drugs total cholesterol, triglycerides, liver function tests, HDL &LDL levels

Antilipemic Drugs Flashcards

(57 cards)