drugs that reduce cholesterol

class: bile acid sequestrants

cholestyramine

class: HMG-CoA reductase inhibitors

atorvastatin

class: cholesterol absorption inhibitors

ezetimibe

alternative therapy

garlic and omega-3 fatty acids

indications of cholestyramine

hypercholesterolemia

MOA of cholestyramine

binds bike acids in the GI tract, which forms an insoluble complex. this forces the liver to use more cholesterol to make more bile acids. results in a increased clearance of cholesterol and reduces LDL cholesterol

interactions of cholestyramine

interacts with many medications including oral contraceptives

adverse effects of cholestyramine

constipation, GI upset

patient teaching for cholestyramine

increase fiber and fluid to counteract constipation. take with food and a full glass of water. will interfere with fat soluble vitamins (ADEK). take other medications 1 hr before or 4 hrs after taking these medications

indications of atorvastatin

hypercholesteromia, prevention of CAD

MOA of atorvastatin

inhibits HMG-CoA reductase, an enzyme responsible for catalyzing an early step in the synthesis of cholesterol. decreases LDL and increases HDL

adverse effects of atorvastatin

hepatotoxicity, muscle pain (myopathy), rhabdomyolysis

nursing considerations of atorvastatin

monitor liver function and CK levels, not given during pregnancy

patient teaching for atorvastatin

avoid alcohol and grapefruit. report muscle pain or cola-colored urine (rhabdo). take it in the evening as cholesterol is synthesized at night

indications of ezetimibe

hypercholesterolemia

MOA of ezetimibe

inhibits the absorption of cholesterol in the small intestines

adverse effects of ezetimibe

hepatotoxicity, muscle pain

nursing considerations for ezetimibe

monitor liver and CK function

indications of garlic

hyperlipidima

believed MOA of garlic

contains allicin and sulfur compounds that may inhibit cholesterol synthesis, vasodilate, and have an antiplatelet effect

adverse effects of garlic

smell like garlic, GI upset, increased bleeding

nursing considerations for garlic

inckude in medication reconciliation, use caution with blood thinners

patient teaching for garlic

report unusual bruising or bleeding

indications of omega-3 fatty acids

hypertriglycerdemia, cardiovascular protection

believed MOA of omega-3 fatty acids

decrease triglyceride synthesis in liver, anti-inflammatory and anti-platelet properties. my improve endothelial function and stabilize atherosclerotic plaques

adverse effects of omega-3 fatty acids

fishy aftertaste/burps, GI upset, bleeding

nursing consideration for omega-3 fatty acids

increased bleeding risk for pts on other blood thinning medications

patient teaching for omega-3 fatty acids

take with meals to reduce GI upset, report unusual bruising or bleeding