Pharm 2. chapter 47 Lipid-Lowering Agents

The patient has been prescribed lovastatin to treat mixed lipidemia. In addition to monitoring cholesterol levels, what other laboratory test value needs to be monitored on a routine basis during therapy?

AST and ALT

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

Bile acids

Which of the following would be classified as a bile acid sequestrant?

Cholestyramine

Which of the following best reflects the action of ezetimibe?

Decreases the absorption of dietary cholesterol from the small intestine

Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived?

Diet

As part of a routine physical examination, a 60-year-old patient's primary care provider has ordered blood work that includes cholesterol levels. What result would most strongly suggest the need for treatment with an antihyperlipidemic drug?

Elevated LDL levels

Which of the following medications is classified as a fibric acid derivative (fibrate)? (Choose one)

Gemfibrozil (Lopid)

The nurse instructs a client to take the prescribed pravastatin at bedtime based on the understanding about which of the following?

Greater drug effectiveness is achieved at this time.

The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values?

HDL 58 LDL 96 Cholesterol 178

Which drug will be most effective in reducing the major types of dyslipidemia?

HMG-CoA reductase inhibitors

What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism?

His dietary intake of saturated fat

HMG-CoA reductase inhibitors (statins) are in which pregnancy category? (Choose one)

Pregnancy Category X

What should the nurse suggest to assist a client to improve his cholesterol levels?

Smoking cessation

Your patient, a 37-year-old woman with moderately elevated lipid levels, requests immediate pharmacotherapy for her dyslipidemia. You explain that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered. You explain the rationale for this regimen as:

Therapeutic lifestyle changes are the preferred method for lowering blood lipids.

Cholesterol is the base unit for the formation of steroid hormones.

True

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness. The client states barely being able to move the extremities because of weakness. The nurse suspects the client has:

rhabdomyolysis.

A patient with primary hypercholesterolemia has been prescribed 10 mg of ezetimibe per day by a physician. The physician has instructed the nurse to continue the drug therapy for 3 days. The drug is available in 10 mg capsules. How many capsules of the drug should the nurse administer the patient during the entire therapy?

3 capsules

Which of the following activities increases high-density lipoproteins?

All of these

A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients?

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

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for which of the following?

Bleeding

A patient who has been taking lovastatin (Mevacor) 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 (Questran)

A patient is taking cholestyramine (Questran) to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which of the following medications?

Digoxin (Lanoxin)

A 57-year-old female client is postmenopausal. Lifestyle changes have not made a significant impact on her lipids. What would the nurse expect the physician to suggest?

Estrogen replacement therapy

A patient with hyperlipidemia is prescribed ezetimibe. Which of the following ongoing assessments should the nurse perform during treatment?

Frequently monitor blood cholesterol.

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

Gallbladder

The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which of the following is a fibrate?

Gemfibrozil

The most common adverse effects of lovastatin include which of the following?

Headache and flatulence

Increased levels of low-density lipoprotein (LDL) combined with certain risk factors can lead to the development of which medical condition? (Choose one)

Heart Disease

A client's serum cholesterol is 286 mg/dL. Lovastatin (Mevacor) is prescribed. The nurse plans care based on the fact that the action of lovastatin does which of the following?

Inhibits the production of cholesterol

Which of the following lipid levels would the nurse interpret as being high?

LDL cholesterol of 190 mg/dL

A patient is taking lovastatin (Mevacor). Which of the following is noted as the most common adverse effects?

Nausea, flatulence, and constipation

A patient who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by her primary care physician. What do these laboratory tests indicate in this patient?

The development of metabolic syndrome

After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic?

Triglyceride level above 150 mg/dL

A patient with metabolic syndrome usually has increased plasminogen activator levels.

True

A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it

inhibits cholesterol syntheses.

Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient's cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drugs achieves its therapeutic effect by

oxidizing cholesterol to bile acids.

Prior to administering an antihyperlipidemic to a client, what information does the nurse need to gather? Select all that apply:

• Dietary history • Vital signs • Weight

After reviewing the various agents used to lower lipid levels, the students demonstrate understanding of the information when they identify which agents as stimulating the breakdown of lipoproteins from the tissues and their removal from the plasma? Select all that apply.

• Fenofibrate • Gemfibrozil

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

• Total cholesterol • Triglycerides • LDL

Which of the following are examples of modifiable risk factors for hyperlipidemia? (Select all that apply)

• Weight • Diet

Niacin is prescribed to a patient to increase HDL levels. What are the most common adverse effects of this therapy? (Select all that apply.)

• Flushing of the face • Nausea and stomach upset

What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? Select all that apply:

• Reason for taking the prescribed drug • Drug name • Correct dose • Frequency of administration • Dosage form