Pharm PrepU Ch. 47: Lipid-Lowering Agents

A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility?

flushing of the skin

The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin?

headache and flatulence

The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?

"Some people get very flushed skin when they take this medication."

The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug?

"the most common side effects of atorvastatin include some mild GI upset"

A client is currently taking propranolol (Inderal) for migraines, glipizide (Glucotrol) for diabetes, and acetaminophen (Tylenol) for osteoarthritis. If cholestyramine was given to this client, what would likely result? Select all that apply:

- the client would experience an increase in migraines due to decreased absorption of propranolol - the client would experience hyperglycemia from decreased absorption of glipizide

This medication is a bile acid sequestrant that promotes the oxidation of cholesterol to bile acids

Colestipol

Bile acid sequestrants may decrease absorption of what medication?

Digoxin

Most cholesterol synthesis occurs when?

During nighttime

After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)?

Gemfibrozil

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

Gemfibrozil

The use of bile acid resins, like cholestyramine, decreases the absorption of what medications?

Glipizide, propranolol

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

Which drug is most effective in reducing most major types of dyslipidemia in patients at risk or who have already developed CAD?

HMG-CoA reductase inhibitors

A 54-year-old client has a cholesterol level of 240 mg/dL (6.2064 mmol/L). What serum concentration of cholesterol would this client have?

High

What is considered to be a high cholesterol level?

High is rated at > 240 mg/dL (6.2064 mmol/L)

What is the indication for cholestyramine?

Indicated to reduce LDL levels in clients who are already taking a statin drug

Statins are contraindicated in clients with what disorder?

Liver disorders

HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?

Pregnancy Category X

A nurse is caring for several clients. Which client would have the greatest chance of developing CAD as determined by total cholesterol?

a 62-year-old white client with total cholesterol of 260 mg/dL

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

A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication:

at bedtime

Which lipid level would the nurse interpret as being high? a. total cholesterol level of 200 mg/dL b. LDL level of 190 mg/dL c. Triglyceride level of 160 d. HDL level of 48

b. LDL level of 190 mg/dL

A nurse is responsible for patient education for a 48-year-old woman who has been prescribed colestipol. The nurse will instruct the patient to take the medication

before a meal

A patient with atrial fibrillation is receiving warfarin therapy. The patient is also prescribed ezetimibe. The nurse would instruct the patient to watch for:

blood in the urine or stool

A client is taking cholestyramine. The nurse will assess for which common adverse effect of the drug?

constipation

In addition to being synthesized in the liver and intestine, from where are blood lipids derived?

diet

A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication?

digoxin

Patients with severe renal disease may have ________ plasma concentration of lovastatin because 10% of the drug is eliminated in the urine

increased

An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy?

liver panel

A client is taking lovastatin. Which are noted as the most common adverse effects?

nausea, flatulence, constipation

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

smoking cessation

Blood lipids, which include cholesterol, phospholipids, and triglycerides, are derived from what

the diet or synthesized by the liver and intestine

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

total cholesterol, LDL, triglycerides

Which category of blood lipids is involved in the formation of atherosclerotic plaques?

cholesterol

A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply.

diet, weight

The nurse knows that part of the education plan for a client with the diagnosis of hyperlipidemia needs to include which lifestyle changes? (Select all that apply.)

reduction of the intake of saturated fats, increased physical activity, and weight loss

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

Which would be classified as a bile acid sequestrant?

Cholestyramine

A nurse is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for a(n):

increase in plasma concentration of lovastatin

A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that:

it decreases the absorption of cholesterol in the small intestines

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

A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of:

muscle pain

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

true

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

elevated LDL levels

What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia?

therapeutic lifestyle changes are the preferred method for lowering blood lipids