NPRO1000 Final cholestyramine (Bile Acid Sequestrant) and atorvastatin (HMG CoA Reductase inhibitor)

A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating:

"I will take the digoxin about an hour before the cholestyramine."

The absorption of digoxin can be decreased or delayed with cholestyramine, a bile acid sequestrant. Therefore, the digoxin should be taken

1 hour before for 4 to 6 hours after the cholestyramine.

Increased serum levels and resultant toxicity can occur if a statin is combined with warfarin, an oral anticoagulant. This would increase the client's risk for bleeding.

Abdominal pain and cataract development are related to the use of atorvastatin alone. Liver failure also is associated with atorvastatin use alone.

A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client?

An obese male client who is a heavy alcohol user and who has cirrhosis of the liver

HMG-CoA reductase inhibitors, such as atorvastatin, block the enzyme involved in cholesterol synthesis.

Bile acid sequestrants block bile acids to form insoluble complexes for excretion in the feces.

Which substance would a group of students identify as being responsible for breaking up dietary fats into smaller units?

Bile acids -cholestyramine

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for:

Bleeding

When describing the action of atorvastatin- Lipitor- HMG CoA Reductase Inhibitor, which would the nurse include?

Blocking the enzyme that is involved in cholesterol synthesis

A client is taking atorvastatin calcium to reduce serum cholesterol. Which aspect of client teaching is most important?

Call the health care provider if muscle pain develops.

Which would be classified as a bile acid sequestrant?

Cholestyramine

A nurse is caring for a client receiving cholestyramine to improve his blood lipid profile at a home care setting. What adverse reactions to cholestyramine should the nurse monitor in the client?

Constipation The nurse should monitor for constipation in the client receiving cholestyramine

A male client takes cholesterol absorption inhibitors as a monotherapy without statins. He develops mild hepatic insufficiency. What would the nurse expect the health care provider to do?

Decrease the dosage of his medication

After teaching a group of students about fats and biotransformation, the instructor determines that the teaching was successful when the students identify what as the storage location of bile acids?

Gallbladder

The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs?

HMG-CoA reductase inhibitors or statin

What might a client report of during treatment with an atorvastatin - Lipitor- HMG CoA Reductase Inhibitor? (Select all that apply.)

Headache Insomnia Constipation

What information would be included in a lipoprotein profile? Select all that apply:

LDL Total cholesterol Triglycerides

A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?

Liver disease

The presence of fatty acids, lipids, and cholesterol in the duodenum stimulates contraction of the gallbladder and the release of bile, which contains bile acids.

Once their action is completed, they are reabsorbed and recycled to the gallbladder, where they remain until the gallbladder is stimulated again.

A client is taking cholestyramine and ezetimibe. What administration guideline is most important to teach this client?

The administration of ezetimibe is 1 hour before cholestyramine.

Clients should be advised to notify their health care provider if unexplained muscle pain or tenderness occurs.

The client should avoid saturated fats when taking statins but should not entirely eliminate fats from the diet. The client should not decrease the dose of statins without the health care provider's knowledge. The client should not increase the intake of eggs due to the increase in cholesterol.

Bile acids act like a detergent in the small intestine and break up fats into small units.

These small units are called micelles. High levels of cholesterol are part of bile acids. Chylomicrons are carriers for micelles.

Cholestyramine is administered to clients to reduce LDL cholesterol in clients who are

already taking a statin drug.

A client who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime?

cholestyramine

HMG-CoA reductase inhibitors or statins are the most widely used dyslipidemia drugs. They are useful in treating most of the major types of

dyslipidemia.

Lipitor is an HMG-CoA reductase inhibitor (statin). Adverse effects of statins include

headache, dizziness, insomnia, flatulence, abdominal pain, cramping, constipation, and nausea.

Which single class drug is known to be most effective in reducing the major types of dyslipidemia?

statins

Active liver disease is a contraindication to the use of

statins. As well, heavy alcohol use increases the risk of liver dysfunction.