easy
what are lipids comprised of?
cholestrol and trigylergdes
MOA of chlorestraymine( bile acid sequestrant)?
binds to bile acids causing them to be excreted in the feces, then liver gets tricked into using the excess cholestrol to make new bile acid
how can you manage Hyperlipidemia?
- diet, low fat lean meat
-excersice daily
-weight management
-medications
MOA of statins:
(ik these questions are annoying but she said she will ask for MOA sooo)
-inhibits the enzyme responsible for hepatic synthesis of chol. ( shuts down prod of chol in liver)
why is chloestramine not used as much?( bile acid seqestrant)
bc it acts as a magnet and pulls out everything, making statins/or any drugs your taking less effective. vitamin supplementation may be needed since its pulling everything out( ADEK)
these 2 meds are used in combination with statins?
chloryestramine and ezetimbe
chorestrol absorbtion inhbitor and bile acid seqestrant
what is primary HLD and Secondary
primary- genetic/ family hx
secondary-r/t other conditions like DM, obesity, hypothyroid
what is a restriction/ bbw that all these drugs have in common?
catagory x, do not use in pregnacy
which medication is given only if the TG is over 500
fenofibrate - fibric acid
what is the most common type of fat in the blood stream?
TG
tell us the normal ranges for TG, LDL AND HDL?
HEHE
TG <150
LDL<130
HDL>40 IN MEN AND >50 IN WOMEN
The nurse sees fatty deposits on her pt body and hand, the nurse asks her "what does your diet look like" and she says shes on a carnivore diet. What is this called when their is visable deposits of fat?
explain what LDL HDL is?
Ldl is leading death factor r/t cvd, carries chlestrol to the cells
HDl is good, carry lipo protein away and to liver to get broken down
why is it reccomnded to take statins at night?
cholestrol is made most in the body at night, want the drug level to be highest at night
which drugs can cause statin toxicity and mess with the cyp450 system?
azole antifubgals
macrolide antibiotics
fibric acid
grapefruit juce
what is contraindications for fenofibrate?
pt w severe renal/ liver diease( fibrate can cause or worsten it)
when evaluating a pt for risk factor and mangement of hyperlipidemia what is the first aspect you will look at??
lifestyle comes first
your pt is starting to take fenofibrate and you notice shes been taking warfarin at a high dose, what is your next action? and why?
decrease warfarin dose, if we keep the dose, shes at risk for bleeding from anticoag.
What is the main risk factor is someone has high TG?
risk for pancreatitis
what is atherosclerosis? how is it formed
plaque build up over time on the blood vessel causing CVD and CAD
this medication is has a severe SE that can cause muscle breaking down releasing bad enzmymes into blood stream; bad muscle pain. but it the best at lowering LDL, increase HDL and lower TG
statins
a patient is inquiring about a new drug she heard of to help with her high chloestrol " alirocumab", how would you explain this drug to the pt? ( what does it do, what is good for)
it increases the activity of receptors that clear chloestrol out
its given subq, it has been well tolerated and great at lowering LDL, although it is expenisve and not covered by most insurances
this drug is not used much anymore due to limited benifits( only works on tg and raises HDL) and has bad SE like facial flushing, hepatoticity and rashes?
niacin
what is the MOA for cholestrol absorbtion inhibitors?
-to block billary and dietary cholestrol absorbtion
*ezetimbe
decreases LDL, TG and increases HDL
less used
what would you tell a pt who is asking about statins; but is prediabetic?
statins increase blood glucose at higher doses, can put pt at risk for diabetes, caution use or chose another option