drug therapy for dyslipidemia

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Pharmacology
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1

serum lipid values

card image
2

antilipidemics

  • decrease blood lipids
  • prevent/delay atherosclerotic plaque development
  • promote regression of existing atherosclerotic plaque
  • reduce morbidity and mortality from cardiovascular disease
3

statins

  • inhibit cholesterol synthesis (decrease LDL, increase HDL)
  • may be combined with other drugs to decrease BP and blood clotting and enhance antihyperlipidemic effect
4

what happens to cholesterol and LDL levels when statins are withdrawn

  • return to pretreatment levels.
  • lifetime commitment
  • can lead to threefold rebound effect that may cause death from AMI
5

MOA of rosuvastatin

inhibits enzyme necessary for hepatic production of cholesterol

6

administration of rosuvastatin

  • takes 2 wks. for maximum therapeutic effects
  • give with food to decrease GI discomfort
  • pregnancy category X
7

AE of rosuvastatin

rhabdomyolysis

8

food interaction of rosuvastatin

grapefruit juice inhibits metabolism of statins, allowing them to reach toxic levels

9

MOA of cholestyramine

binds bile acids to intestinal lumen and cause it to be excreted through feces

10

use of cholestyramine

hyperlipidemia type II

11

administration of cholestyramine

powder form, do not take with other meds

12

AE of cholestyramine

not systemically absorbed

  • GI effects (abd. fullness, flatulence, diarrhea, constipation)
13

MOA of gemfibrozil

decrease hepatic production of triglycerides, VLDL, and increase HDL

14

use of gemfibrozil

hyperlipoproteinemia and hypertriglyceridemia

15

AE of gemfibrozil

  • GI discomfort
  • gall stones
  • pulmonary embolus
16

MOA of ezetimibe

blocks biliary and dietary cholesterol absorption in intestine

17

use of ezetimibe

hypercholesterolemia and hyperlipoproteinemia

18

administration of ezetimibe

  • take same time each day
  • best effect when combined with statin
19

AE of ezetimibe

  • rhabdomyolysis
  • arthralgia
20

MOA of niacin acid

reduces bad cholesterol and increase good cholesterol

21

use of niacin

  • effective in increasing HDL
  • used with statin to lower LDL
22

AE of niacin

  • flushing
  • pruritus
  • gastric irritation
23

administration of niacin

  • reduce flushing by taking ASA 325mg 30 minutes prior to niacin
  • ibuprofen 200mg 60 minutes before niacin
  • take with cold water
  • different from nicotinamide
24

S/S to report while on statin

report unusual or unexplained muscle tenderness, increasing muscle pain, numbness/tingling to extremities or change in ADLs

25
  • S/S to report while on bile acid resins
  • report nausea, heartburn, constipation
  • tarry stools or yellowing of sclera or skin
26

S/S to report while on niacin

  • report flank, joint, or stomach pain
  • report yellowing of sclera or skin
27

S/S to report while on fibrin acid agents

  • report unusual bleeding or bruising
  • report right upper quadrant pain, muscle cramping or changes in color of stool