16 Fibrates Antilipidemics

Fibrates example

Gemfibrozil (Lopid)

Fibrates purpse

lowers (very high) triglycerides

Fibrates effects on the body

Triglycerides _____

HDL _____

LDL _____

fall the most, rises, changes little

Fibrates: Gemfibrozil is given twice daily during what condition

30 min before breakfast/dinner

Fibrates monitor

lipid panel, LFTs, CK, INR if also on warfarin

Fibrates indications

very high triglycerides (500mg/dL or more), lowers risk of pancreatitis

Fibrates contraindications

sever liver or kidney disease, gallbladder disease (gallstones), gemfibrozil with simvastatin

Fibrates side effects

upset stomach, belly pain, diarrhea, rash, dizziness

Fibrates adverse effects

myopathy, rhabdomyolysis, higher with statins (toxicity), gallstones (cholelithiasis), liver injury, bleeding risk with warfarin

Fibrates client education

30 min before meals (gemfibrozil), report right upper abdomen pain, muscle pain, weakness, dark urine, if taking warfarin or statin

Fibrates CJMM recognize cues

Right upper belly pain, muscle pain, INR, clay-colored stools

Fibrates CJMM analyze cues

Gallstones, muscle injury, or warfarin effect?

Fibrates CJMM prioritize hypothesis

Possible rhabdomyolysis or bleeding first

Fibrates CJMM generate solutions

Plan INR checks and dose timing

Fibrates CJMM take actions

Notify provider; teach 30 minutes before meals

Fibrates CJMM evaluate outcomes

Triglycerides fall; no belly or muscle pain