Chapter 10: Drug Therapy for Dyslipidemia Flashcards
(27 cards)
Accumulation of abdominal body fat, resulting in an increased waist circumference.
Central adiposity.
Component of the cell membrane that is produced and processed in the liver, a fat essential for the formation of steroid hormones that are produced in cells and taken in by dietary sources.
Cholesterol
Abnormal lipid levels in the blood; associated with atherosclerosis and its many pathophysiologic effects. (Myocardial ischemia and infarction, stroke, peripheral arterial occlusive disease.)
Dyslipidemia.
Specific proteins in plasma that transport blood lipids; contain cholesterol, phospholipid, and triglyceride bound to protein. They vary in density and amounts of lipids and proteins.
Lipoproteins
A cluster of several cardiovascular risk factors linked with obesity; increased waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol. elevated blood pressure, and elevated fasting glucose.
Metabolic syndrome.
Total serum cholesterol (mg/dL) in Adults:
Desirable = <200 Borderline = 200–239 Undesirable = 240 or above
LDL cholesterol (mg/dL) in Adults:
Desirable = <130 Borderline = 130–159 Undesirable = 160 or above
HDL cholesterol (mg/dL) in adults:
Desirable = 40 or above* Undesirable = <40
Triglycerides (mg/dL) in Adults:
Triglycerides (mg/dL) Desirable = <150 Borderline = 150–199 Undesirable = 200 or above
Total serum cholesterol (mg/dL) in children:
Desirable = <170 Borderline = 170–199 Undesirable = 200 or above
LDL cholesterol (mg/dL) in children:
Desirable = 110–129 Undesirable = >130 or above
HDL cholesterol (mg/dL) in children
Desirable level = >45 Borderline = 35–45 Undesirable = <35
Triglycerides (mg/dL) in children:
Desirable = <125 Undesirable = >125 or above
What is Cholestyramine?
Cholestyramine (Prevalite, Questran), the prototype bile acid sequestrant, has the ability to reduce LDL cholesterol. It has little or no effect on HDL cholesterol and either no effect or an increased effect on triglyceride levels.
Route and dosage ranges of Cholestyramine: Prevalite, Questran
PO tablets, 4 g once or twice daily initially, gradually increased at monthly intervals to 8–16 g daily in 2 divided doses. Maximum daily dose, 24 g PO powder, 4 g 1–6 times daily
Route and dosage range of Fenofibrate (Antara, TriCor, Lofibra, Trilipix)
Fenofibrate (micronized) PO 67 mg three times daily with meals increased if necessary to a maximum dose of 268 mg (4 capsules) daily
Ezetimibe (Zetia) Route and dosage range:
PO 10 mg once daily.
Drugs that increase the effects of Atorvastatin:
Magnesium and aluminum containing antacids: Interfere with absorption.
Amiodarone and colchine: Decrease metabolism.
Azole Antifungals: Increase the risk of myopathy recommended that statin therapy be interrupted.
Cyclosporine, CYPA34 inhibitors, diltiazem, fibric acid derivatives, niacin, verapamil: Increase the risk of severe myopathy or rhabdomyolysis.
Erythromycin, macrolide antibiotics, nefazodone, and protease inhibitors Decrease elimination
Drugs That Decrease the Effects of Atorvastatin
Cholestyramine Decreases rate of bioavailability; administer atorvastatin at least 4 hours after this bile acid sequestrant. Colestipol Decreases plasma levels
Drugs That Increase the Effects of Fenofibrate
Statins Increase the risk of severe myopathy or rhabdomyolysis Cyclosporine Mechanism for increase is unknown.
Drugs That Decrease the Effects of Fenofibrate
Bile acid sequestrant drugs Decrease absorption; to avoid, take fenofibrate about 1 hour before or 4 to 6 hours after the bile acid sequestrant.
Drugs That Increase the Effects of Ezetimibe
Cyclosporine Increases blood levels
Drugs That Decrease the Effects of Ezetimibe
Bile acid sequestrant drugs Mechanism for decrease is unknown.
What drugs can Cholestyramine decrease the absorption of?
Cholestyramine may decrease absorption of many oral medications (e.g., digoxin, folic acid, glipizide, propranolol, tetracyclines, thiazide diuretics, thyroid hormones, fat-soluble vitamins, and warfarin).
