chapter 10- dyslipidemia Flashcards by Madison Gibbons

what is dyslipidemia

high cholesterol

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what component are triglycerides

a sugar

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what is within a lipid-protein

cholesterol, phospholipid, triglyceride

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what synthesizes lipids

the liver and intestine

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what do lipids control

energy sources

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what are the three most common diagnoses in the US

HTN, diabetes, high cholesterol

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what is metabolic syndrome

Conditions that occur together that increase the risk of heart disease
-doubles it!

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what are the conditions of metabolic syndrome

-Central or abdominal obesity
-increased triglycerides
-high LDL –lousy lipid
-low HDL – good lipid
-increased BP
-Increased glucose

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what is dyslipidemia/hyperlipidemia a risk factor for

CAD
-atherosclerosis
-pathophysiologic effects
-MI and ischemia
-CVA
-PAD

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what is primary hyperlipidemia

genetic, mutation of the LDL receptor. 1/500 people have this.

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what is secondary hyperlipidemia

caused by dietary habits and/or other diseases

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symptoms of high cholesterol

-loose stool
-depression
-stomach distention
- poor appetite
-weight gain
-heart pain
-fatigue
-cholesterol pockets — normally seen by eyes
-aching pain in joints

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what should total cholesterol be?
borderline?
high?

-less than 200 mg
-200 to 239 mg
-more than 240 mg

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what should LDL cholesterol be?
Alright?
borderline?
high?
very high?

-less than 100 mg
-100-129 mg
-120-159
-160-189
-190 or above

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what should HDL cholesterol be?
alright?
low?

-60 mg or higher
- 40-59 mg
- less than 40 mg

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when should cholesterol panels be drawn

in the morning, after a fast

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what is the Mediterranean diet

-olive oil
-legumes
-fruit and veggies
-fish
-dairy

medications that affect cholesterol

-atenolol
-amiodarone
-prednisone
-diuretics

what can be a solution for post-menopausal women

hormone replacement

what food category can you increase in your diet

fiber

how do HMG-CoA reductase inhibitors work
“statins”

decrease cholesterol production, decrease total cholesterol and LDL, VLDL, without affecting HDL– may actually increase

common statins

ATORVASTATIN
-pravastatin
-lorostatin
-rosuvastatin
-simvastatin

side effects of statins

MYALGIA –muscle dysfunction, pain, weakness, in the legs, will keep on med unless it can not be tolerated.
-nausea
-constipation/diarrhea

what meds do statins interact with

mg+ antacids. “azole” antifungals, some antibiotics, cholestyramine

when to give and what to avoid with statins

give in the evening that's when synthesized -no grapefruit or pomegranate -red rice yeast -vitamin B3 PREGNANCY --- normally not given if possible rhabdomyolysis or changes to liver enzymes!

how do bile acid sequestrants work what is the main one?

binds to bile acid in the intestine causing excretion, can not be recirculated in the liver, and makes the acid from cholesterol, lowering LDL. cholestyramine

pharmacokinetics of cholestyramine

not absorbed orally, unchanged in stool. will take effect within a week and reach peak within a month

Side effects of cholestyramine

GI fullness, flatulence (gas), constipation/diarrhea

what to know about the administration of cholestyramine

decreases absorption of other drugs: glipizide (DM), folic acid, propranolol, thiazide diuretics, thyroid hormone, warfarin decreases: A, D, E, K Fiber will increase the effect GIVE 1 hour before or 4-6 HOURS AFTER other beds ideally early morning or late night

how do fibrates work? common fibrates?

increase oxidation of fatty acids in the liver and muscle, decrease production of triglycerides, VLDL and increase HDL fenofibrate and gemfibrozil

common side effects and who cannot have them?

Gi discomfort, diarrhea, GALLSTONES NOT FOR PEOPLE WITH GALLBLADDER ISSUES

medication interactions with fenofibrate and gemfibrozil and when to take them

can enhance warfarin, increase kidney side effects with statins, decrease the effect of bile acid meds Gemfibrozil should be taken on an empty stomach, 30 minutes before eating

how do cholesterol absorption inhibitors meds work? most common med?

inhibit the absorption of cholesterol in the intestine, leading to decreased levels in the liver, increasing clearance from the blood EZETUNIBE

side effects of ezetimibe

HA, diarrhea, nausea

what is it normally taken with, and when should it not be taken

can be taken by itself or with a statin should not be taken during pregnancy

how do PCSK9 inhibitors work, and when are they used

inactivates the protein in the liver that regulates the lifespan of cholesterol. can cause a 60-70% decrease in LDL. used on people with genetic hypercholesterol on max statin dose

example of PCSK9 med, how it is administered, and side effects

alirocumab sub Q every 2-4 weeks, doses vary itching, nasopharyngitis and muscle pain

how does niacin B3 work, side effects, and when can it not be used

boosts levels of HDL and lower triglycerides and LDL S: facial flushing, stomach upset, diarrhea, RAISED BLOOD SUGAR cant be used with liver issues, stomach ulcers, changes to glucose, muscle damage, low BP, heart rhythm changes

main complaint of using Omega 3 fatty acids and what types are there

fishy aftertaste -acid ethyl esters and carboxylic acids

examples of combination therapy

Advicor: extended release of niacin and lovastatin Simcor: simvastatin and niacin Niacin dose can change within both