Question | Answer |
what are lipids | diverse group of non polar molecules that are stored as energy or serve as hormones; 3 kinds: neutral, phospholipids and steroids |
what are the three types of lipids | Triglycerides: natural fat, energy source, 90% of total lipids in body.
Phospholipids: replace one of fatty acids in triglyceride, builds plasma membranes.
Steroids: cholesterol is a steroid that is natural and vital component of plasma membranes. |
Hyperlipidemia | High levels of lipids in the blood, major risk for cardiovascular disease. May be inherited or acquired |
Hypercholesterolemia | Elevated blood cholesterol |
Dyslipidemia | Abnormal (excess were deficient) levels of lipoprotein's |
Types of cholesterol | High density lipoprotein (HDL)= good cholesterol
low density lipoprotein (LDL)= bad cholesterol |
Standard lab values for lipids | Total cholesterol: <200 is desirable
LDL-cholesterol: moderate risk level starts at 130
HDL cholesterol: > 60 is desirable
triglycerides: <149 desirable |
Pt teaching hyperlipidemia | Monitored blood lipid levels
maintain weight; exercise
reduce dietary saturated fats and cholesterol
increase soluble fiber in diet
reduce or eliminate tobacco use
use of plant sterols in stanols |
Atorvastatin/Lipitor
lovastatin/Mevacor
rosuvastatin/Crestor
simvastatin/Zocor | Classification: HMG-CoA reductase inhibitors/statins
therapeutic class: anti-hyperlipidemic inhibits HMG-COA reductase by making more LDL receptors and increase the removal of LDL from the blood. |
STATINS- drug interactions | antifungal's, HIV protease inhibitors, telaprevir, macrolide antiobotics- myopathy and rhabdomyolysis. Atorvastatin may ^ levels of digoxin and BC. Erythromycin increase affect of atorvastatin. No ethanol due of effects liver function. |
Statins
side effects & food/herbal interactions | Side effects: H/A, GI issues, liver damage, rhabdomyolysis (muscle breakdown), liver disease.
No grapefruit juice- poss toxicity. Red yeast rice ^ effects of atorvastatin. CoQ10 supplements may be needed. |
Cholestyremine/ Questran | Class: anti-hyperlipidemic Questran bile acid sequestrant that binds w bile acids and excreted through feces.
admin: mix powder w 60 to 80 mL H2O. Give stat to avoid irritation or obstruction of G.I. tract. Other meds given 2hr prior/4 hr after questran |
cholestyremine/ Questran
drug/food/herbal interactions | drug: Digoxin, penicillins, thyroid hormone, thiazide diuretics binds with questran and interfere with absorption. questran increase anticoagulants by decreasing vitamin K.
herb/food: give on an empty stomach may interfere with nutrients. |
cholestyremine/ Questran
side effects | side effects: Constipation, bloating, gas, nausea.
Contradictions: total biliary obstruction with prior hypersensitivity to drug
Preg cat C
May take 30 days to reach maximum effect |
ezetimibe/ Zetia | class: anti-hyperlipidemic- Cholesterol absorption inhibitors that blocks absorption in the small intestines causing less cholesterol to enter the blood.
side effects: nasal pharyngitis, myalgia, URI, arthralgia, diarrhea.
preg cat C. given w statin |
Hyperlipidemic Drugs | Prior assessments: hx of cardiovascular, musculoskeletal, GI, poss preg.
tx assessments: LFT'S, LIPIDS, CK (CREATINE KINASE), uric acid levels.
side: musculoskeletal, GI, Decreased ADL's, yellow sclera/skin, constipation, tarry stools, numb/ting |
hyperlipidemic lifespan | Older adults metabolism and excretion decreases.
Monitor ethnically pts for Max effects and min adverse effects. Hispanics/native Americans gallbladder
0 pregnancy or breast-feeding/lactation
older risk of bleeding due to vit K def, dizziness. |