Exam 4 - Chapt 23 - Lipid Disorders

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How to lower cholesterol through lifestyle:
- monitor blood-lipid levels
- maintain optimum weight
- exercise plan
- reduce saturated fats and cholesterol
- increase soluble fiber
- reduce or eliminate alcohol
- eliminate tobacco
what should the triglyceride level be?

<150
what should the total cholesterol be?

<200
What should the HDL be?
- >40 - men
- >50 - women
what should the LDL be?

<100
What should the total/HDL ratio be?

<5 or (HDL/LDL > .3)
Name the weaker statin "sisters"
- lovastatin (Mevacor)
- fluvastatin (Lescol
- pravastatin (Pravachol)
Name the stronger statin "sisters"
- simvastatin (Zocor
- atorvastatin (Lipitor)
- rosuvastatin (Crestor)
What are the different drug classes for lipid disorders?
- HMG-CoA Reductase Inhibitors (Statins)-lower LDL
- Bile acid resins - Lower LDL
- Nicotinic acid, Niacin Vit B3 - increase HDL
- Fibric acid agents - increase HDL
- Cholesterol absorption inhibitors - lower cholesterol
What is the mechanism of action of HMG-CoA Reductase Inhibitors (Lipitor) atorvastatin?
- inhibits HMG-CoA Reductase in the liver
- Lowers LDL and cholesterol
what are the minor adverse effects of HMG-CoA Reductase Inhibitors (Lipitor) atorvastatin?
- headache
- fatigue
- muscle or joint pain
- heartburn
- neuropathy
what are the SEVERE adverse effects of HMG-CoA Reductase Inhibitors (Lipitor) atorvastatin?
- severe myopathy
- rhabdomyolysis
- increase in LFT's
- increase in CPK (creatinine)
what are the nursing considerations and client teaching of HMG-CoA Reductase Inhibitors (Lipitor) atorvastatin?
- check LFT's first
- NO ETOH
- Lipitor can be taken any time of day (longer 1/2 life)
- Take statins at night
- Report muscle pain or weakness, immediately
- NO grapefruit
Why take statins at night?
- Liver works primarily at night to produce LDL
- statins best taken at night
What is the mechanism of action of Bile-Acid Resins Sequestrants (Questran) cholestyramine?
- binds with bile acids which contain high levels of cholesterol
- eliminated in feces
- lowers LDL by 20%
What are the adverse effects of Bile-Acid Resins Sequestrants (Questran) cholestyramine?
- bloating
- constipation
- abdominal pain
- *can bind with other drugs increasing potential for drug interactions
- *additive effects with HMG-CoA reductase inhibitors and nicotinic acid
what are the nursing considerations and client teaching of Bile-Acid Resins Sequestrants (Questran) cholestyramine?
- do not take with other drugs
- take with food
- mix with water
What is the mechanism of action of Nicotinic Acid-Niacin (Vitamin B3)?
- decreases VLDL (triglyceride) levels
- decreases LDL levels by 20%
- increases HDL levels
what are the minor adverse effects of Nicotinic Acid-Niacin (Vitamin B3)?
- flushing (ASA-30 min prior to dose may help)
- hot flashes
- nausea
- excess gas
- diarrhea
what are the SEVERE adverse effects of Nicotinic Acid-Niacin (Vitamin B3)?
- hepatotoxicity
- gout
- increased blood sugar
- *not to be used with statins due to increased occurrence of rhabdomyolysis
- *may potentiate effects of anti-HTN and vasoactive drugs
What are the nursing considerations and client teaching of Nicotinic Acid-Niacin (Vitamin B3)?
- take TID
- with or without meals
what is the mechanism of action of Fibric-Acid agents (Lopid) gemfibrozil?
- unknown
- treats sever hypertriglyceridemia
- lowers VLDL by 50%
- increases HDL levels
What are the adverse effects of Fibric-Acid agents (Lopid) gemfibrozil?
- GI distress (watch for GI bleed with anticoagulants)
- myalgia (ck CPK)
- rash
- fatigue
- cholylithiasis
- pancreatitis
- liver toxicity
What are the nursing considerations and client teaching for Fibric-Acid agents (Lopid) gemfibrozil)?
- give 30 min prior to am/pm meals
- NO ETOH
What are the labs monitored for statin drugs?
- LFT's
- CPK
- triglyceride
- total cholesterol
- LDL
- HDL
what is hyperlipidemia?

high level of lipids in the blood
what is hypercholesterolemia?

the type of hyperlipidemia that is most familia to the general public
what is rhabdomyolysis?
- breakdown of muscle fibers
- due to muscle trauma or ischemia
what carries cholesterol through the blood?

lipoproteins (LDL, HDL, triglycerides)
what carries cholesterol away from the arteries and to liver and out of the body?

HDL
which kind of cholesterol builds as plaque on arteries?

LDL
What is the pregnancy category of atorvastatin (Lipitor)?

Category X
what percent of cholesterol comes from food?

25%
what does dietary cholesterol come from?
- animal products
- meat
- eggs
- milk products
- butter...
how much cholesterol should be consumed in a day?

<300mg / day
What is the mechanism of action of Cholesterol Absorption Inhibitors (Vytorin) combo Zocor/Zetia)?
- inhibits absorption of cholesterol
- lowers LDL by 20%
What are the adverse effects of Cholesterol Absorption Inhibitors (Vytorin)?
- hepatitis
- myopathy

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Exam 4 - Chapt 23 - Lipid Disorders

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Exam 4 - Chapt 23 - Lipid Disorders

Updated

2017-03-20T21:35:14Z

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