Quiz Questions on Antilipemic Drugs
intense facial flushing->take Aspirin before dose; pruritus (itching); GI distress; hepatotoxicity
Adverse effects for nicotinic acid?
hepatotoxicity, myopathy: weakness and muscle pain, Rhabdomyosis: widespread muscle breakdown, increased CPK and CK lab values(!!!!)
Adverse effects of statins?
decrease TG (triglycerides) 20-50%, decrease LDL 5-25%, increase HDL 15-35%
Drug effects for nicotinic acid?
Niacin/Niacor/Niaspan
Examples of nicotinic acid?
Atorvastatin/Lipitor and Simvastatin/Zocar
Examples of statins?
transports lipids out of vessel walls; normal levels for men ≥40 mg/dL and women ≥50 mg/dL
High-density lipoproteins (HDL)?
made in the liver primarily at night
How is cholesterol synthesized and where does it take place?
lousy cholesterol; transports cholesterol into the vessel wall; normal levels <100 mg/dL
Low-density lipoproteins (LDL)?
B3 niacin, B vitamin
Mechanism of action for nicotinic acid?
aspirin in 325 mg before dose to reduce flushing
Nursing implications for nicotinic acid?
max effect occurs within 4-6 weeks; monitor LFT, CK, and CPK; assess for muscle weakness
Nursing implications for statins?
take at night, report muscle weakness, avoid alcohol because of liver
Patient education for statins?
total amount of cholesterol in blood; should be <200 mg/dL
Total cholesterol definition
decrease LDL by 25-63% (depends on dosage)
What are the drug effects for statins?
exercise five times per week 30-60 min of moderate intensity; no trans fat; reduce cholesterol to <20g; saturated fat should be <7% of total fat bc increases LDL production; increase soluble fiber ≥25 g/day; intake of stanols/sterols should be 2 g/day; BMI should be between 18.5-24.9; no smoking
What are the recommended therapeutic lifestyle changes to reduce cholesterol?
total cholesterol goal is <200 mg/dL; LDL goal is <100 mg/dL; HDL goal is ≥40 in men and ≥50 mg/dL in women; triglycerides goal is <150 mg/dL
What are the therapeutic goals of drug therapy for hyperlipidemia according to ATP III?
lipids that are stored in body cells; normal levels <150 mg/dL
What are triglycerides?
don't give HMG-CoA reductase inhibitor to pregnant lady or else baby will be born without skin
What is the black box warning for statins?
decrease cholesterol by inhibiting HMG-CoA reductase; may decrease inflammation
What is the mechanism of action for statins?
LDL is directly linked to the development of coronary artery disease (CAD); CAD is number one killer of men and women in US; it initiates and fuels the development of artherosclerosis
What is the relationship between cholesterol and atherosclerosis and coronary artery disease (CAD)?
S/S of hepatotoxicity: elevated LFT (liver function test AST/ALT), anorexia/nausea, tea urine, clay stool, yellowing, RUQ pain
What should the nurse be aware of in regards to statins?
enzyme that starts reaction that results in cholesterol
What's the role of HMG-CoA reductase in cholesterol synthesis?
no Crestor for Asians; no grapefruit juice because has CYP 450 inhibitor->statin breakdown
contraindications for statins?