Dyslipidemia

Question 1

What is the desired range of Cholesterol?

Answer 1

150-200 mg/dL

Question 2

What is the desired range of Triglycerides?

Answer 2

40-150 mg/dL

Question 3

What is the desired range of LDL?

Answer 3

<100 mg/dL

Question 4

What is the desired range of HDL?

Answer 4

> 60 mg/dL

Question 5

What are the general characteristics of Antidyslipidemics?

Answer 5

Decrease blood lipids

Prevent/delay atherosclerotic plaque development

Promote regression of existing atherosclerotic plaque

Reduce mortality from Cardiovascular disease

Question 6

What are the actions of Statins?

Answer 6

Inhibit cholesterol synthesis; Inhibit enzyme HMG-CoA reductase in cholesterol biosynthesis.

Decreases LDL and slightly increases HDL

Question 7

What could happen if a patient abruptly stops taking their Statins?

Answer 7

Threefold rebound effect that may cause death from Acute MI

Question 8

What drug is classified as Antihyperlipidemic?

Answer 8

Rosuvastatin

Question 9

What is the MOA of Rosuvastatin?

Answer 9

Inhibits cholesterol synthesis in the liver. Decreases the concentration of cholesterol, decreases LDL and slightly increases HDL.

Question 10

What is Rosuvastatin used for?

Answer 10

Decrease LDL levels

Hypercholesterolemia

Hyperlipoproteinemia

Atherosclerosis

Cardiovascular risk reduction in diabetes mellitus

Question 11

What ASE should a nurse be worried about with Rosuvastatin?

Answer 11

Muscle Aches (may be indicative of Rhabdomyolysis)

Elevated liver enzymes

Myopathy

Hepatotoxicity

Question 12

What is contraindicated to Rosuvastatin?

Answer 12

Acute hepatic disease and pregnancy (category X drug. Will cause birth defects)

Question 13

What should be taught to a patient taking Rosuvastatin?

Answer 13

May take several weeks before lipid levels decrease

Patient needs to have their liver enzymes monitored.

Question 14

What drug is classified as a Fibrate?

Answer 14

Gemfibrozil

Question 15

What is the MOA of Gemfibrozil?

Answer 15

Decrease hepatic production of triglycerides, VLDL< and increase HDL

Question 16

What is Gemfibrozil used for?

Answer 16

hyperlipoproteinemia and hypertriglyceridemia. Used as secondary to statins.

Question 17

What ASEs are associated with Gemfibrozil?

Answer 17

GI discomfort, Diarrhea, gallstones.

Question 18

What drug is classified as Cholesterol Absorption Inhibitor?

Answer 18

Ezetimibe

Question 19

What is the MOA of Ezetimibe?

Answer 19

Blocks biliary and dietary cholesterol absorption in intestine.

Question 20

What is Ezetimibe used for?

Answer 20

Hypercholesterolemia and Hyperlipoproteinemia

Question 21

How is Ezetimibe administered?

Answer 21

Take at same time each day.

Question 22

What ASEs are associated with Ezetimibe?

Answer 22

Headache, diarrhea, arthralgia, abdominal and back pain, rhabdomyolysis.

Question 23

What drug is classified as Vitamin B3?

Answer 23

Niacin.

Question 24

What is the MOA of Niacin?

Answer 24

Reduces total cholesterol, LDL, VLDL and triglyceride levels; Increases HDL

Question 25

What is Niacin used for?

Answer 25

Most effective at increasing HDL, use with statin to lower LDL

Question 26

What ASEs are associated with Niacin?

Answer 26

Flushing, gastric irritation, pruritus( itching)

Question 27

How should Niacin be administered?

Answer 27

Give ASA 325 mg 30 minutes prior to or ibuprofen 200 mg 60 mins before giving niacin. This is to reduce flushing. Take with cold water.

Question 28

What should be educated to patients with Niacin?

Answer 28

OTC Niacin is called nicotinamide. THE OTC DOES NOT HAVE LIPID-LOWERING EFFECTs

Question 29

What drug is classified as PSK9 inhibitor?

Answer 29

Alirocumab

Question 30

Indications for Alirocumab?

Answer 30

Drug resistant hypercholesterolemia and familial hypercholesterolemia

Question 31

What is the action of Alirocumab?

Answer 31

Reduce LDL. Can reduce even more LDL with Statins.

Question 32

What is the MOA of Alirocumab?

Answer 32

Blocks PSK9, thus reducing plasma LDL levels.

Question 33

How do you administer Alirocumab?

Answer 33

SQ. Injection every 14 or 28 days.

Question 34

What should be monitored with Alirocumab?

Answer 34

Lipid panel. Cholesterol Levels.

Question 35

What are the side effects of Alirocumab?

Answer 35

Injection site reactions Hypersensitivity rash

Question 36

Can a nurse give Alirocumab by itself?

Answer 36

No, it is always accompanied with other medications.

Question 37

What drug is classified as a Bile Acid Sequestrant?

Answer 37

Cholestyramine

Question 38

What is the MOA of Cholestyramine?

Answer 38

Forms a resin that limits reabsorption of bile acids in the intestines which causes bile acids to be excreted in feces.

Question 39

What is Cholestyramine used for?

Answer 39

To lower LDL, diarrhea, and itching caused by liver disease.

Question 40

What are ASEs associated with Cholestyramine?

Answer 40

GI effects such as flatulence, constipation, osteoporosis, Vitamin A,D,K deficiency.

Question 41

How is Cholestyramine administered?

Answer 41

Powder. Mix with food.

Question 42

What should the nurse be aware of with Cholestyramine?

Answer 42

Avoid taking other medications with Cholestyramine. Wait at least 4-6 hours after administrations or before taking any other medications or take other medications 1 hour before taking Cholestyramine b/c Cholestyramine can make it harder for other medications to be absorbed.

Question 43

What Signs/Symptoms should a patient with Statins report on?

Answer 43

Unusual muscle tenderness, increasing muscle pain, numbness to extremities, or change in ADLs

Question 44

What Signs/Symptoms should a patient with Bile Acid Resins?

Answer 44

Report severe nausea, heartburn, constipation, or straining with passing stools.

Question 45

What Signs/Symptoms should a patient with Niacin?

Answer 45

Report flank, joint or stomach pain. Report yellowing of sclera or skin

Question 46

What Signs/Symptoms should a patient with Fibric Acid Agents?

Answer 46

Report unusual bleeding, bruising, right upper quadrant pain, muscle cramping, or changes in the color of stool.