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Terminology
Lipids
Cholesterol
Lipoprotein:
LDL:
HDL:
Triglycerides:
Atherosclerosis:
ASCVD:
HMG-CoA-reductase:
Myopathy:
Rhabdomyolysis:
Creatine kinase (CK):
all fats in the blood
fatty substance used to build membranes/hormones
carries cholesterol/fat through blood
“Bad” cholesterol in artery walls
“good” cholesterol that carriers it back to liver
sugary fats stored for energy (alcohol, oil)
fat.plaque buildup→ narrow/stiffen
heart attack, stroke
liver enzyme statins block → less cholesterol
muscle pain or weakness caused by a drug
severe muscle breakdown (dark urine)
enzyme that rises when muscle is breaking down
Cholesterol
Function?
Orgin?
Education for diet?
VLDL:
High LDL and triglycerides →
Goal:
hormone synthesis and fat absorption
liver
decrease saturated fats
Very-low-density lipoprotein (transports triglycerides)
atherosclerosis, ASCVD
High HDL/ Low LDL = Lower CV risk
HMG-CoA Reductase Inhibitors
Prototype:
suffix:
MOA:
Therapeutic Uses:
Adverse Effects:
Contraindications:
Drug interactions:
Adminstration:
Client Teaching:
Atorvastatin
-statin
decrease LDL, triglycerides & increase HDL
Hypercholesterolemia, Primary/Secondary prevention of coronary events, Prevention of MI/stroke (diabetes)
Hepatotoxicity ( increased AST) & Myopathy/Rhabdomyolysis (muscle pain, dark urine)
Pregnancy, grapefruit juice, asian descent
fibrates, ezetimibe, CYP3A4 inhibitors
Evening dosing preferred ( cholesterol synthesized at night)
Avoid alcohol, report muscle pain or jaundice, use contraception
Fibrates (Fibric Acid Derivatives)
Prototype
MOA:
therapeautic uses:
Adverse effects:
Drug interactions:
Contraindications:
Education:
Admin?
gemifibrozil & Fenofibrate
decrease triglycerides, increase HDL & lipoprotein lipase
HIgh triglycerides not controlled by lifestyle & modest increased HDL
Myopathy/rhabdomyolysis, Hepatotoxicity, Gallstones ( increase biliary cholesterol), GI upset
Warfarin displacement (protein-bound) → increased INR/bleeding… Statins → increase myopathy risk
liver disease, renal impair, gallbladder disease, older adults, pregnancy
Report RUQ pain/fat intolerance, musclepain/weakness, dark urine, jaundice
BID, 30 min before breakfast & dinner