Lipid Lowering agent

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Author:
Prittyrick
ID:
277849
Filename:
Lipid Lowering agent
Updated:
2014-06-29 20:03:29
Tags:
pharm
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Description:
i thought i was done with this thing for 6 weeks
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  1. Names
    cholesterol synthesis inhibitors
    • Most have the -statins in them
    • lovastatin (mevacor)
    • simivastatin (zocor)
    • atrovastatin (lipitor)

    • The most effective
    • effects seen in two weeks full effects 4 weeks
  2. Use chol synthesis inhibitor
    • to decrease LDL, cholesterol 
    • often given in 2ndary prevent of MI
  3. MOA chol synthesis inhibitor
    • interfers with cholesterol synthesis
    • inhibits HMG CoA reductase (enzyme) that causes hepatocytes to synthesizes more LDL receptor
    • thus more LDL is removed from the body

    • Lowers
    • primary LDL and also VLDL
    • increases HDL
  4. SE NI cholesteral syn. inhibitor
    • SE
    • few, GI, H/A, rash, muscle wasting and weakness

    • NI
    • check LFT
    • contrain- with Liver disease
    • teach pt to continue with non pharm methods- low fat diet
    • give in the PM 
    • tell pt to report s/s of muscle weakness
    • avoid pregnancy
  5. Bile sequencing Names, uses, MOA, Effect
    • Name
    • Questran
    • Colestipol

    Use: decre LDL, may increase VLDL temporarily, used when other meds don't work

    • MOA: forms insoluble complexes with bile acids in the GI tract preventing the reabsorption of bile acid and increase its excretion
    • this triggers the liver to synthesis bile acid from cholesterol and plasma level will decrease

    effect seen in 1st week full will be a month
  6. bile sequencing se
    • GI
    • constipation- most commons
    • nausea
    • indigestion
    • bloating
    • decrease uptake of fat soluble- A D E K
  7. bile sequencing NI
    • not given to pt w/high VLDL
    • need to watch for fat soluble defenciences 
    • teach pt to continue non pharm methods
    • admin before meals
    • choles level will return to baseline after d/c for a month
  8. Fibric acid derivatives
    Gamfibrozil

    use- lowers VLDL, increase HDL

    MOA: inhibits peripheral lipolysis, decre the hepatic extraction of fatty acid, decreasing hepatic triglyrides 

    Contraind.- incr risk of hepatic maligancy, hepatic or severe renal dysfunction, pregnancy and breastfeeding

    SE: GI (common), hyperglycemia, may cause anemia, leukopenia

    NI: LFT, monitor CBC, adm before meals
  9. Nicotinic acid
    niacin

    • uses reduces levels of triglycerides, LDL, cholesterol, increase HDL
    •  
    • MOA unknown

    dose to treat chol is much higher than used to treat defiency

    initial effects are seen in 4-7 days max in 1 month

    Contrain- hepatic dysfunction, active peptic ulcer, severe hypotension, hemmorhaging

    SE: few- peripheral vasodilation, flushing, pruritis, GI most serious hepatoxicty (rare)

    • NI
    • monitor LFT
    • adm with meals
    • cuteneous flushing, itching, H/a may occur w/in 2 hrs: side effects are transient
    • slow position change (orthostatic hypo)

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