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75 Cards in this Set
- Front
- Back
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What are good HDL levels?
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HDL greater than 40
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What are good LDL levels?
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LDL less than 100
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What are good triglyceride levels?
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TG less than 150 (over 500 is very high)
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What contributes most to cardiovascular disease?
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high LDL
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What is the first thing done to control high LDL levels?
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therapeutic lifestyle changes
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What is important to tell patients about treating cholesterol with drugs?
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That drug therapy is for life, and not to stop TLC
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What is the first-line drug therapy for high cholesterol?
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Statins
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What is atorvastatin (lipitor)?
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statin
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What is simvastatin (zocor)?
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statin
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What is the most effective drug for lowering LDLs?
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statins
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What are the therapeutic effects of statins on cholesterol?
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reduce LDL
increase HDL reduce TG |
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What are the added benefits of using statins to treat cholesterol?
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promote plaque stability
reduce the risk for CV events increase bone formation |
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What are the therapeutic uses of statins?
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hypercholesterolemia
prevention of CV events post MI therapy diabetes |
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What are the rare SE of statins?
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myopathy
rhabdomyolysis hepatotoxicity peripheral neuropathy |
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What disease is connected to high cholesterol levels?
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parkinson's disease
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Can statins be used during pregnancy?
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no
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What drug interactions are important for statins?
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other lipid lowering drugs
other drugs that inhibit CYP |
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When should statins be administered, and why?
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once daily in the evening
b/c cholesterol is synthesized at night |
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What are the therapeutic effects of niacin (nicotinic acid)?
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reduces LDL and TG
Increases HDL (more effectively than other drugs) Decreases VLDL |
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What is nispan?
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nicotinic acid / niacin
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What is the most significant adverse effect of nicotinic acid?
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skin flushing and itching
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How can the flushing from nicotinic acid be treated?
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can pretreat with aspirin
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What does nicotinic acid do that can negatively impact cardiovascular health?
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can raise blood levels of homocystine
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How are bile acid-binding sequestrants used?
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used in conjunction with statins
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What is cholestyramine (questran)?
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bile acid-binding seqestrants
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What is colestipol (colestid)?
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bile acid-binding seqestrants
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What is colesevelam (welchol)?
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bile acid-binding seqestrants
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Why is colesevelam different than other bile acid-binding sequestrants?
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they do not decrease fat soluble vitamin absorption
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What is the therapeutic effect of bile acid-binding sequestrants?
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reduces LDL
increases VLDL (in some patients) |
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What is the main SE of bile acid-binding sequestrants?
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constipation
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What is the most effective drug for lowering TG levels?
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fibric acid derivatives
(fibrates) |
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What are the significant drug interactions with fibrates?
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warfarin - increases the risk of bleeding (competes for albumin binding sites)
statins - increases the risk for rhabdomyolysis |
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When taking fibrates and warfarin what tests need to be done?
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need a regular INR blood tests
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What is gemfibrozil (lopid)?
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fibrate
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What is fenofibrate?
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fibrate
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What is fenofibric acid?
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fibrate
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What is lovaza?
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omega 3
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What do you need to teach a patient who is taking omega 3?
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to watch other oils they are eating
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How do we get cholesterol?
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food (exogenous)
liver (endogenous) |
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What is the primary treatment for hypercholesterolemia?
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diet and exercise
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What are HMG CoA reductase inhibitors?
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statins
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Which drugs are the most effective in lowering LDL cholesterol?
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statins
(HMG CoA reductase inhibitors) |
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How do the HMG CoA reductase inhibitors (stains) work?
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blocking reductase prevents liver from producing cholesterol
causes body to produce more LDL receptors more receptors for fewer cholesterol molecules |
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Statins are more effective when taken with what other drug?
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bile acid-binding resins
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What side-effect might cause adherence issues with bile acid-binding resins?
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cause gas and bloating
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When a patient is taking statins, what regular tests need to be performed?
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liver function tests
CPK (released from damaged heart muscles) to watch for rhabdomyolysis |
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What would you teach a patient being discharged on Lipitor?
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it is a statin
speeds removal of cholesterol from the blood takes 2 weeks to work 4-6 weeks for max effect better to take at night with or without food lifelong rx |
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Which statin causes the least muscle aches, but is also least effective?
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mevacor (lovastatin)
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What special instructions do patients on mevacor (lovastatin) need that is different from others in its class?
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take with food to increase bioavailability
(other statins can be taken with or without food) |
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What is prevachol (pravastatin)?
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statin
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What is zocor (simvastatin)?
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statin
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What is crestor (rouvastatin)?
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statin
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How do bile acid-binding resins lower cholesterol?
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resins form an insoluble complex with bile acids in the intestines to accelerate their excretion
this creates more demand for bile acid which is made from LDL cholesterol |
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Can bile acid-binding resins be used in pregnant women?
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no, category X
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What are the major side-effects of bile acid-binding resins?
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GI bloating, indigestion and nausea
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Which drugs create insoluble complexes when given with bile acid-binding resins - so they shouldn't be given together?
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thiazide diuretics
digoxin warfarin |
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When should drugs that bind with bile acid-binding resins be given?
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1 hour before or 4 hours after the resin drugs
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What is the drug of choice for lowering VLDL?
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nicotinic acid (niacin)
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Which cholesterol lowering drugs should not be given together and why?
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lopid (gemfibrozil) and statins, because they increase risk of myopathy
warfarin, because it displaces the albumin binding site |
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The patient is prescribed lovastatin (mevacor). The nurse will teach the patient to take the medication when?
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with the evening meal
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The nurse will teach a patient who is prescribed niacin (niacor) to prevent flushing of the face by taking _______.
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aspirin
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HMG CoA reductase inhibitors benefit patients by doing what?
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stabilizing endothelial plaque
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A patient has been prescribed cholestramine in addition to other drugs for diabetes and hypertension. What does the patient need to know about administration?
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1 hour before or 4 hours after other drugs
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What is the goal of drug therapy with hyperlipidemia?
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lower LDLs
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How long do people need to take cholesterol-lowering drugs?
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for a lifetime
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Which drugs are most effective at lowering LDLs?
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statins
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Which drug increases HDL levels better than others?
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Niacin
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Nicotinic acid reduces LDL by __% and TG by __%.
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LDL 5-25%
TG 20-50% |
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What percentage of patients on niacin have adverse effects?
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nearly all
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What is ezetimibe?
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cholesterol-reducing drug
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Which drugs are most effective at lowering TG?
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fibrates
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What is advicor?
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a combo of lovastatin and niacin
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What is simcor?
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simvastatin and niacin
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What is vytorin?
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simvastatin and ezetimibe
only indicated for hypercholesterolemia |
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What is pravigard PAC?
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pravatatin and aspirin
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