pharm_BCP_lipids

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Author:
itzlinds
ID:
263361
Filename:
pharm_BCP_lipids
Updated:
2014-02-23 10:54:52
Tags:
birth control lipid lowering
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Description:
birth control and lipid lowering
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  1. during the menstrual cycle, which hormone predominates the 7-10 days before ovulation (the days after each menses):
    estrogen
  2. which hormone predominates the 2 weeks after ovulation (the 2nd half of the cycle)
    progesterone
  3. what does the decrease of estrogen secretion stimulate:
    the anterior pituitary to release LH and FSH

    the LH and FSH spike causes ovulation
  4. what is the MOA for BCP:
    prevents the normal drop in estrogen that stimulated LH and FSH production 

    without LH and FSH the ovarian follicle doesnt mature and ovulation doesnt occur

    BCP may also make the uterine lining less accepting of a fertilized egg so it may be aorifiactant
  5. what do you tell a pt. to do if one pill is missed:
    2 pills are taken the next day
  6. what do you tell a pt. to do if 2 consecutive pills are missed:
    back up birth control should be used until a new cycle is started

    2 tablets should be taken on the day the missed dose was remembered, and again the following day, then start regular schedule should be resumed, with back up birth control
  7. list the 3 categories of estrogen-progestin OCs:
    • monophasic
    • biphasic
    • triphasic
  8. a constant dose of estrogen and progestin throughout the 21 day tx cycle is called:
    monophasic
  9. the amount of estrogen in each pill remains constant, but the amount of progestin is increased toward the end of the tx cycel is called:
    biphasic
  10. the amount of both estrogen and progestin vary in 3 distinct phases during the tx cycle, called:
    triphasic
  11. what are is the failure rate for progestin only (minipills):
    failure of progestin only: 1-4%

    failure rate for traditional estrogen -progestin pills are less than progestin only!
  12. what is the pregnancy category for BCP:
    category X
  13. what are the contraindications for OCP/BCPs:
    • pregnancy
    • current breast cancer
    • severe hepatic cirrhosis
    • major surgery with prolonged immobilization
    • migraines
    • imparied cardiac fxn
    • complicated valvular heart disease
    • HTN
    • smoking
    • hx of stroke
    • systemic lupus erythematosus
    • thromboembolic disorders
  14. what are the adverse effects of OCP/BCPs:
    • HTN, or increased BP
    • increased glucose levels
    • weight gain
    • fatigue
    • depression
    • acne
    • hirsutism
    • nausea
    • edema
    • brest tenderness
  15. what are the contraindications for HRT:
    • personal or family hx of breast or liver cancer
    • any estrogen-dependednt cancer
    • fx of abnormal mammograms
    • hx of gall bladder disease
    • DM
    • liver or kidney disease
    • HTN
    • Clots
    • CAD
    • smoking
  16. estrogens...

    estrace
    estradiol
  17. estrogens...

    premarin
    estrogen, conjugated
  18. progestins...

    provera
    medroxyprogesterone
  19. estrogen-progestin combinations..

    prempro
    conjugated estrogens/medroxyprogesterone acetate
  20. the major storage form of fat in the body and the only type of lipid that serves as an important energy source is:
    triglycerides
  21. what is the structure of triglycerides:
    3 fatty acid molecules attached to a glycerol molecule
  22. what is the structure of phospholipids:
    • 1 phosphorus molecule
    • 2 fatty acid molecules
    • ..attached to a glycerol molecule
  23. lipids with a common chemical feature of sterol nucleus, or ring structure is are called:
    steroids
  24. an essential steroid part of the plasma membrane of cells and a building block for a # of biochemical is:

    list 5 biochemical
    cholesterol

    • biochemicals
    • vitamin D
    • bile acid
    • cortisol
    • estrogen
    • testosterone
  25. because lipid molecules are not soluble in plasma, they must be specially packaged for transport through the blood, called:
    lipoproteins
  26. the lipoprotein that contains the most protein, up to 50% by weight are called:
    high density lipoproteins (HDL)
  27. the lipoprotein that has a high amount of cholesterol (fat) and little protein is called:
    low density lipoprotein (LDL)
  28. which lipoprotein transports cholesterol from the liver to the tissues and organs, where it is used to build plasma membranes or to synthesize other steroids:
    LDLs
  29. which lipoprotein is called the "bad" cholesterol due to is contribution to plaque deposits and coronary artery disease:
    LDLs
  30. the primary carrier of triglycerides in the blood is:
    very low density lipoprotein (VLDL)
  31. which lipoprotein is manufactured in the liver and small intestine and assists in transport of cholesterol away from the body tissues back to the liver:
    HDLs
  32. what is the MOA for statins:
    inhibit HMG-CoA reductase, which results in less cholesterol biosynthesis

    as the liver makes less cholesterol, it responds by making more LDL receptors on the liver cells

    more LDL receptors increases the removal of LDL from the blood
  33. what are the adverse effects of stains:
    • headache
    • fatigue
    • muscle or joint pain
    • heartburn
    • GERD
    • rhabdomyolysis
    • myopathy
  34. when are statins with a short half life to be given:

    why:
    statins with short half lives such as lovastatin should be administered in the evening

    why: cholesterol synthesis in the liver is higher at NOC
  35. a breakdown of muscle fibers usually due to muscle trauma, the contents of the muscle cells spill into the systemic circulation, causing potentially fatal acute renal failure is called:
    rhabdomyolysis
  36. which drugs should be avoided because they can interfere with statin metabolism and increase the risk of rhabdomyolysis:
    • macrolide antibiotics such as....
    • erythromycin
    • azole antifungals
    • fibric acid agents
    • certain immunosuppressants
  37. what are the s/sx of rhabdomyolysis:
    • painful, swollen, tender or bruised areas of the body
    • muscle weakness; having trouble moving arms/legs
    • nausea/vomiting
    • confusing
    • dehydration
    • fever
    • lack of consciousness
    • dark urine
    • no urine output
  38. what foods/fluids should a pt. avoid when on a statin:
    grapefruit juice
  39. statins also decrease the synthesis of:
    coenzyme Q10

    pts. may benefit from taking a CoQ10 supplement

    • CoQ10 deficiency includes..
    • High BP
    • CHF
    • low energy
  40. what are the contraindications for statins:
    • pregnancy
    • breast feeding
    • increased LFT
    • liver disease
    • excess alcohol intake
  41. what is the pregnancy category for statins:
    category x
  42. what is the MOA for bile acid sequestrants:
    bind to bile acids, which have a high concentration of cholesterol, and are eliminated in the feces

    the liver responds to the loss of cholesterol by making more LDL receptors , which remove more cholesterol from the blood
  43. which type of lowering agent is best at lowering the LDL levels:
    bile acid sequestrants
  44. bile acid -binding agents:

    questran
    cholestyramine
  45. bile acid binding agents..

    welchol
    colesevelam
  46. statins..

    lipitor
    atorvastatin
  47. statin

    crestor
    rosuvastatin
  48. statin

    zocor
    simvastatin
  49. what type of drug is simvastatin:
    statin

    zocor
  50. what type of drug is atorvastatin?
    statin

    lipitor
  51. what are the adverse effect of bile acid sequestrants:
    they are large molecules, not absorbed so can cause GI side effects...

    • bloating
    • constipation
    • flatus
    • abdominal pain
    • n/v/d
    • steatorrhea (excess fat in the feces)
    • obstruction
  52. which agent is preferred for primarily elevated triglycerides:
    niacin
  53. what can be done to decrease the flushing/hot flashes that occurs with prescription-strength niacin:
    taking aspirin 30 minutes before niacin

    avoid taking it with hot fluids
  54. fibric acid agents...

    tricor
    fenofibrate
  55. fibric acid agents...

    lopid
    gemfibrozil
  56. zetia
    ezetimibe
  57. nicobid
    niacin
  58. Combines with bile acids and cholesterol          the GI tract thus decreasing cholesterol absorption.  This causes the liver to pull more LDL cholesterol out of the blood, lowering the serum cholesterol level:
    bile acid resins
  59. Decreases triglycerides, thus indirectly decreases the cholesterol level

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