Chapter 16 Flashcards by Danielle renner

Name the different types of drug therapies for Cholesterol Managment

HMG-CoA reductase inhibitors
Bile-acid sequestrants
Cholesterol absorption inhibitors
Fibrates
Nicotine acids

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How do HMG-CoA reductase inhibitors work

they control the rate of cholesterol produced by the liver which decreases total cholesterol, decreases LDL and decreases triglycerides

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What is the suffix of HMG-CoA reductase inhibitors

statin
atorvastatin
simvastatin

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What are the side effects of statin drugs

muscle aches, GI upset, liver problems

usually they go away

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What are the adverse effects of statins

Decreased liver fx, need a liver test q 3-6months, Rhabdomyolysis which can lead to kidney failure

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what do you check before giving statin drugs

kidney and liver function, check for muscle problems and alcohol consumption

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What do you check after giving statin drugs

liver function and assess for muscle breakdown

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What do you teach your patient about statin drugs

Can take them at bedtime if it upsets their stomach, or they can be taken twice per day

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Lifespan considerations for statin drugs

not for children under 8, not for pregnancy (X), not for patients with myopathy or liver disease

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What is the suffix of Bile Acid Sequestrants

cole
cholestyramine
colesevelam
colestipol

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What are side effects of Bile Acid

GI upset

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What are adverse effects of Bile Acid (cole)

decrease in body’s ability to absorb oral drugs, inhibit fat soluble vitamins (A,D,E, and K) they may need a vitamin supplement, can increase or decrease the effects of warfarin

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What do you check before you give Bile Acid (cole)

Give at least 2 hours before or 4-6 hours after taking other oral drugs, watch for problems with constipation

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What do you check after you take Bile Acid (cole)

assess for constipation, and other GI problems, if patient is taking warfarin, monitor for s/s of bleeding (clammy, easily bruising, paleness, dizziness, increased HR, decreased BP, SOB, or confusion)

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What do you teach your patients taking Bile Acid (cole)

Take at least 2 hours before taking other oral medications or 4-6 hours after, tablet forms should be taken with 12-16oz of water (to prevent bowel obstruction), take WITH meals so that it can bind with the cholesterol, and take 2 hours before/after antacids

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What Bile Acid is safe for pregnant women

Colestipol

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What is the suffix for Cholesterol Absorption Inhibitors

EZE

esetimible

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When are Cholesterol Absorption Inhibitors used

when low fat/low cholesterol diets didn’t work, or when statins side effects were too bad, they can also be paired with statin

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What are the side effects of Cholesterol Absorption Inhibitors (eze)

GI discomfort, diarrhea, rash, fatigue, back pain, joint pain, and sinusitis

What are the adverse effects of Cholesterol Absorption Inhibitors (EZE)

Angioedema, liver problems

What does Cholesterol Absorption Inhibitors do

Lower LDL and total cholesterol

What do you check before you give Cholesterol Absorption Inhibitors (eze)

liver disease or muscle disorders

What do you teach the patient taking Cholesterol Absorption Inhibiting (eze)

report muscle pain, tenderness or weakness, take drug once a day at the same time, which will help you remember to take the medication and it can help time intestinal problems

Lifespan considerations for Cholesterol Absorption Inhibitors

Not safe for children under 10, not for pregnant or breast feeding patients

Bile Acid binds with cholesterol where?

In the intestine, which prevents fat absorption, so you poop it out

What is the suffix for Fibrates

fib fenofibrate gemfibrozil

How do fibrates (fib) work

They bind to the cell wall receptors and break down lipids for elimination

What do Fibrates do to cholesterol

decrease trigs and liver production of trigs | increase (mildly) HDL, use of trigs by fat tissues, cholesterol excretion in bile

What are some side effects of Fibrates

GI upset, dyspepsia, muscle problems, rash, pruritis

What are the adverse effects of Fibrates

gallstones, rhabdomyolysis, liver damage

What does Fibrates interact with

grapefruit juice, alcohol, increases warfarin which increases bleeding

What do you check before you give Fibrates

kidney, liver or gallbladder disease

What do you check after giving Fibrates

monitor kidney, liver or gallbladder, bleeding

What do you teach patients taking Fibrate

follow up lab tests, take 30 minutes before morning and evening meals, avoid alcohol, no grapefruit juice, report s/s of bleeding, Older adults will get INR tested weekly

What is the Nicotinic Acid Agent

Niacin (Vitamin B)

What are the intended responses for Niacin

decrease trig, total and LDL, increase HDL by dilating blood vessels

What are the side effects of Niacin

flushing, itching, GI upset, headache, tachy, dizziness, nasal inflammation, hot flashes, SOB, sweating and swelling

What are the adverse affects of Niacin

Liver failure, Gout, Hyperglycemia

What are the contraindications for Niacin

Not for patients with hypertension, peptic ulcer disease, or active bleeding

What do you check before you give Niacin

baseline vitals, blood sugar, BP and HR, history of liver disease, diabetes, alcohol intake and gout

What do you teach about Niacin

Take with meals, tell your dentist, take NSAID or aspirin 30 minutes prior to taking Niacin to reduce flushing and hot flashes

Cholesterol is good for your body (T/F)

True

Which lipid is considered the "good" lipid

HDL

The use of lipid lowering drugs lessens the importance of implementing dietary changes in preventing coronary artery disease (t/f)

False

The side effects of statins disapear as the body adjusts to the medication (T/F/)

True

What are the normal levels of: Total Cholesterol, Trigs, LDL, and HDL

Total: 200 or less Trigs: 40-160, 35-135 LDL: 60-180 HDL greater than 45, 55

When should drug therapy be used for cholesterol?

Drugs should only be used if TLC's (Therapeutic lifestyle changes) fail.