Cholesterol Management and Lipid Profiles

These flashcards cover key concepts related to cholesterol management, lipid profiles, and statin medications.

What do antilipemic agents help manage?

Cholesterol levels by reducing LDL, increasing HDL, and decreasing VLDL cholesterol.

What are some lifestyle modifications recommended for cholesterol management?

Regular exercise, balanced diet, and weight control.

What baseline lab tests are necessary for cholesterol management?

Total cholesterol, LDL, HDL, triglycerides, liver function test, and kidney function test.

What is considered a normal HDL level for men?

≥ 40 mg/dL (≥ 1.0 mmol/L).

What HDL level is optimal and protective against heart disease?

≥ 60 mg/dL (≥ 1.5 mmol/L).

What is the desirable total cholesterol level?

List two examples of HMG-CoA reductase inhibitors (statins).

Atorvastatin and Simvastatin.

What are the therapeutic uses of statins?

Hypercholesterolemia and prevention of coronary events in diabetic clients.

What is a major complication associated with the use of statins?

Myopathy and hepatotoxicity.

What warning is associated with statin use during pregnancy?

Pregnancy warning. Statins can be harmful to fetal development.

What drug interactions may occur with statins?

Rhabdomyolysis may occur with CYP34A4 suppressors like Erythromycin and Ketoconazole.

What should clients avoid when taking statins?

Grapefruit juice, which can interfere with drug metabolism.

What do antilipemic agents help manage?

Cholesterol levels by reducing LDL, increasing HDL, and decreasing VLDL cholesterol.

What are some lifestyle modifications recommended for cholesterol management?

Regular exercise, balanced diet, and weight control.

What baseline lab tests are necessary for cholesterol management?

Total cholesterol, LDL, HDL, triglycerides, liver function test, and kidney function test.

What is considered a normal HDL level for men?

≥ 40 mg/dL (≥ 1.0 mmol/L).

What HDL level is optimal and protective against heart disease?

≥ 60 mg/dL (≥ 1.5 mmol/L).

What is the desirable total cholesterol level?

<200 mg/dL (< 5.2 mmol/L).

List two examples of HMG-CoA reductase inhibitors (statins).

Atorvastatin and Simvastatin.

What are the therapeutic uses of statins?

Hypercholesterolemia and prevention of coronary events in diabetic clients.

What is a major complication associated with the use of statins?

Myopathy and hepatotoxicity.

What warning is associated with statin use during pregnancy?

Pregnancy warning. Statins can be harmful to fetal development.

What drug interactions may occur with statins?

Rhabdomyolysis may occur with CYP34A4 suppressors like Erythromycin and Ketoconazole.

What should clients avoid when taking statins?

Grapefruit juice, which can interfere with drug metabolism.

What is considered an optimal LDL cholesterol level?

ext{<100 mg/dL (<2.6 mmol/L)} optimally.

What is the desirable triglyceride level?

ext{<150 mg/dL (<1.7 mmol/L)}.

How do HMG-CoA reductase inhibitors (statins) work?

They inhibit HMG-CoA reductase, an enzyme necessary for cholesterol synthesis in the liver, leading to decreased LDL and triglyceride levels.

What is the mechanism of action for Ezetimibe?

Ezetimibe works by inhibiting the absorption of cholesterol in the small intestine.

When is the best time for clients to take statins?

Statins are generally most effective when taken in the evening or at bedtime because cholesterol synthesis primarily occurs at night.

What symptoms should clients report immediately when taking statins?

Muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise, indicating potential myopathy or rhabdomyolysis.

What adverse effects are commonly associated with Ezetimibe?

Generally well-tolerated, but can cause mild abdominal pain, diarrhea, and fatigue; rarely, liver enzyme elevations.

Why might Ezetimibe be prescribed in combination with a statin?

To achieve greater LDL cholesterol reduction than with a statin alone, especially in patients who do not reach target LDL levels with statin monotherapy or those who are statin-intolerant.

What is the primary nursing consideration for patients experiencing muscle pain while on statins?

Advise the patient to notify their healthcare provider immediately, as this could indicate myopathy or rhabdomyolysis, requiring discontinuation of the drug and further evaluation.

What is the mechanism of action for Fibrates (e.g., Gemfibrozil, Fenofibrate)?

Fibrates activate peroxisome proliferator-activated receptor alpha (PPAR-alpha), leading to increased lipoprotein lipase activity, which reduces triglyceride levels and can increase HDL cholesterol.

What are the primary therapeutic uses of Fibrates?

They are primarily used to treat severe hypertriglyceridemia, especially in patients at risk of pancreatitis, and can also increase HDL levels.

What are common adverse effects associated with Fibrates?

Common adverse effects include gastrointestinal upset, gallstones, and an increased risk of myopathy, especially when co-administered with statins.

How do Bile Acid Sequestrants (e.g., Cholestyramine, Colesevelam) lower cholesterol?

They bind to bile acids in the small intestine, forming an insoluble complex that is excreted in the feces. This prevents reabsorption of bile acids, prompting the liver to convert more cholesterol into bile acids, thereby reducing circulating LDL-C levels.

What is a key nursing consideration when administering Bile Acid Sequestrants?

Other medications should be administered 1 hour before or 4 hours after bile acid sequestrants to prevent interference with their absorption, due to the binding properties of the sequestrants.

What are common adverse effects of Bile Acid Sequestrants?

Common adverse effects include constipation, bloating, abdominal pain, and potential malabsorption of fat-soluble vitamins (A, D, E, K).

How does Niacin (Nicotinic Acid) affect lipid levels?

Niacin inhibits hormone-sensitive lipase in adipose tissue, reducing the synthesis of triglycerides and the hepatic production of VLDL. This leads to reduced LDL cholesterol and significantly increases HDL cholesterol.

What do antilipemic agents help manage?

Cholesterol levels by reducing LDL, increasing HDL, and decreasing VLDL cholesterol.

What are some lifestyle modifications recommended for cholesterol management?

Regular exercise, balanced diet, and weight control.

What baseline lab tests are necessary for cholesterol management?

Total cholesterol, LDL, HDL, triglycerides, liver function test, and kidney function test.

What is considered a normal HDL level for men?

≥ 40 mg/dL (≥ 1.0 mmol/L).

What HDL level is optimal and protective against heart disease?

≥ 60 mg/dL (≥ 1.5 mmol/L).

What is the desirable total cholesterol level?

<200 mg/dL (< 5.2 mmol/L).

List two examples of HMG-CoA reductase inhibitors (statins).

Atorvastatin and Simvastatin.

What are the therapeutic uses of statins?

Hypercholesterolemia and prevention of coronary events in diabetic clients.

What is a major complication associated with the use of statins?

Myopathy and hepatotoxicity.

What warning is associated with statin use during pregnancy?

Pregnancy warning. Statins can be harmful to fetal development.

What drug interactions may occur with statins?

Rhabdomyolysis may occur with CYP34A4 suppressors like Erythromycin and Ketoconazole.

What should clients avoid when taking statins?

Grapefruit juice, which can interfere with drug metabolism.

What is considered an optimal LDL cholesterol level?

\text{<100 mg/dL (<2.6 mmol/L)} optimally.

What is the desirable triglyceride level?

\text{<150 mg/dL (<1.7 mmol/L)} .

How do HMG-CoA reductase inhibitors (statins) work?

They inhibit HMG-CoA reductase, an enzyme necessary for cholesterol synthesis in the liver, leading to decreased LDL and triglyceride levels.

What is the mechanism of action for Ezetimibe?

Ezetimibe works by inhibiting the absorption of cholesterol in the small intestine.

When is the best time for clients to take statins?

Statins are generally most effective when taken in the evening or at bedtime because cholesterol synthesis primarily occurs at night.

What symptoms should clients report immediately when taking statins?

Muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise, indicating potential myopathy or rhabdomyolysis.

What adverse effects are commonly associated with Ezetimibe?

Generally well-tolerated, but can cause mild abdominal pain, diarrhea, and fatigue; rarely, liver enzyme elevations.

Why might Ezetimibe be prescribed in combination with a statin?

To achieve greater LDL cholesterol reduction than with a statin alone, especially in patients who do not reach target LDL levels with statin monotherapy or those who are statin-intolerant.

What is the primary nursing consideration for patients experiencing muscle pain while on statins?

Advise the patient to notify their healthcare provider immediately, as this could indicate myopathy or rhabdomyolysis, requiring discontinuation of the drug and further evaluation.

What is the mechanism of action for Fibrates (e.g., Gemfibrozil, Fenofibrate)?

Fibrates activate peroxisome proliferator-activated receptor alpha (PPAR-alpha), leading to increased lipoprotein lipase activity, which reduces triglyceride levels and can increase HDL cholesterol.

What are the primary therapeutic uses of Fibrates?

They are primarily used to treat severe hypertriglyceridemia, especially in patients at risk of pancreatitis, and can also increase HDL levels.

What are common adverse effects associated with Fibrates?

Common adverse effects include gastrointestinal upset, gallstones, and an increased risk of myopathy, especially when co-administered with statins.

How do Bile Acid Sequestrants (e.g., Cholestyramine, Colesevelam) lower cholesterol?

They bind to bile acids in the small intestine, forming an insoluble complex that is excreted in the feces. This prevents reabsorption of bile acids, prompting the liver to convert more cholesterol into bile acids, thereby reducing circulating LDL-C levels.

What is a key nursing consideration when administering Bile Acid Sequestrants?

Other medications should be administered 1 hour before or 4 hours after bile acid sequestrants to prevent interference with their absorption, due to the binding properties of the sequestrants.

What are common adverse effects of Bile Acid Sequestrants?

Common adverse effects include constipation, bloating, abdominal pain, and potential malabsorption of fat-soluble vitamins (A, D, E, K).

How does Niacin (Nicotinic Acid) affect lipid levels?

Niacin inhibits hormone-sensitive lipase in adipose tissue, reducing the synthesis of triglycerides and the hepatic production of VLDL. This leads to reduced LDL cholesterol and significantly increases HDL cholesterol.

What is a prominent adverse effect of Niacin, and how can it be mitigated?

Flushing and itching are common due to prostaglandin release. This can be mitigated by taking aspirin 30 minutes before Niacin or by taking Niacin with food.

What are the primary therapeutic uses of Niacin?

To reduce LDL and VLDL cholesterol (triglycerides) and significantly increase HDL cholesterol, often used in combination with other lipid-lowering agents.

What are some serious adverse effects associated with high doses of Niacin?

Hepatotoxicity, hyperglycemia, hyperuricemia (which can worsen gout), and upper gastrointestinal distress.

What monitoring is crucial for patients on Niacin therapy?

Baseline and regular monitoring of liver function tests (LFTs), blood glucose, and uric acid levels are recommended.

What is the mechanism of action for PCSK9 Inhibitors (e.g., Alirocumab, Evolocumab)?

PCSK9 inhibitors are monoclonal antibodies that bind to PCSK9, preventing it from binding to and degrading LDL receptors on liver cells. This increases the number of available LDL receptors, leading to greater clearance of LDL cholesterol from the blood.

Who are PCSK9 inhibitors typically prescribed for?

Patients with familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional LDL-C lowering despite maximally tolerated statin therapy.

How are PCSK9 inhibitors administered, and what are common adverse effects?

They are administered via subcutaneous injection every 2-4 weeks. Common adverse effects include nasopharyngitis, flu-like symptoms, injection site reactions, and back pain.