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pharm 22 def. & Tom

drugs used to treat Dylipidemias

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Vit. K deficiency? How to tell?
belleing gums, bruising, dark tarry stool and coffee ground emesis
FIBRIC ACIDS S/E to expect?
N, diarrhea, flatulence, bloating, abdominal distressD
Misc Antilipemic Agents outcome
reduction of LDL
common S/E of niacin that a Pt should be educated on how to avoid is?
flushing, itching, headache
NIACIN S/E to report?
FATUGUE, ANOREXIA, N, MALAISE, JANUDICE, & MYOPATHY
Antilipemics are used for what?
to treat hyperlipidemias....only if diet, exercise and weight reduction are not successful in lowering LDL levels
FIBRIC ACIDS
drugs gemfigrozil, Fenofibrate
NIACIN outcome?
reduce LDL 5 - 25% and increase HDL by 15- 35%
Drug Class: NIACIN
AKA AS NICOTINIC ACID AND A VIT B inhibits VLDL synthesis in liver...which causes a decrease in LDLs.....
HMG--CoA Reductase Inhibitors S/E to expect
headache. N, abdominal bloating, gas
what else can be used to lower cholesterol levels?
Acid Binding resins (cholestyramine, colestipol, colesvelam) NIACIN, HMG-CoA,, & STATINS
what is cholesterol needed for in our bodies?
synthesizing body steroids used by endocrine system, synthesizing bile acids needed for food absorption, and cell wall synthesis
Purpose of HDL ? (healthy)
transport cholesterol from peripheral cells to the lever for metabolism....the GOOD Lipoprotein......low levels of this are considered a positive risk factor in development of CAD
what lowers Triglyceride levels?
Fibric Acid derivatives and Omega 3 fatty acids
Atherosclerosis (fatty father)
chacterized by accumlation of fatty deposits on inner walls of arteries and arterioles throughout the body....reduces blood supply to viatl organs resulting in Strokes,Angina Pectoris, MI, & PVD Peripheral Vascular Disease
what are the most "treatable" causes of CAD?
Hypertension, Cigarette smoking, Type 2 Diab. and atherosclerosis
NIACIN uses?
is the only vit B approved by FDA to treat dyslipidemias...and this is an inexpensive treatment
Omega-3 fatty acids are often referred to as ?
fish oils
what is primary cause of atherosclerosis?
abnormal elevation of cholesterol and triglycerides in the blood and is known as hyperlipidemia
FIBRIC ACIDS drug interactions?
Warfarin, Sulfonylureas (Insulin), Bile Acid Binding Resins, & HMG-CoA
what foods are high in cholesterol?
liver, egg yokes, meats, fried foods, fatty deserts, and nuts (cashews, macadamia, Brazil)
Drug Class: HMG--CoA Reductase Inhibitors
reductase enzyme inhibitors are most potent antilipemic agenst avail. AKA STATINS...the reduction in liver cholesterol increases the removal of LDL from circulating blood...may reduce by as much as 50%....administer these at night...that is when the peak production of cholesterol is
Liver funtion studies (test?) are not required/recommended before?
Bile Acid-Binding Resins
FIBRIC ACIDS S/E to report?
FATIGUE, ANOREXIA, N, MALAISE, & JAUNDICE
Drug Class: FIBRIC ACIDS
mech. not known...they lower triglycerides levels by 20-40% and raise HDl by 10-15%, also reduce LDL-C by 10-15%
HMG--CoA Reductase Inhibitors outcome?
reduce LDL and total cholesterol levels
BILE ACID BINDING RESINS outcome?
deduce LDL and total cholesterol levels
HMG--CoA Reductase Inhibitors S/E to report?
LIVER DYSFUNCTION, MYOPATHY, RENAL FAILURE
NIACIN S/E to expect
flushing, itching, rash, tingling, headache, N, gas, abdominal discomfort, dizzi, faintness, hypotension
BILE ACID BINDING RESINS drug interactions
Digoxin, Warfarin, Thyroid Hormones, Thiazide Diuretics, Phenobarbital, Beta Blockers, Tetracycline
Misc Antilipemic Agents use
uesd w/ statin to further lower cholesterol
HMG--CoA Reductase Inhibitors uses?
statins are used w/ dietary therapy to decrease cholesterol and reduce the risk of atherosclerosis
Dyslipidemias
is abnormalities w/ one or more of the blood fats (lipids)...caused by genetic abnormalities, 2ndary causes or both....diets high in saturated fats, cholesterol, carbohydrages, total calories and alcohol as well as sedentary lifestyles contribute to this.
Fibric acids are used to lower?
triglycerides
list 3 things that are true about Omacor?
used to decrease very elevated triglyceride levels, is often used w/ statins to further lower cholesterol levels, should be used w. caution in Pt's w/ allergies to FISHd
BILE ACID BINDING RESINS S/E
Constipation, Bloating, Fullness, N, Flatulence
Grapefruit juice should not be taken w/?
HMG-CoA reductase inhibitors
Are Hyperlipidemias treatable?
yes, w/ meds.
Drug Class: BILE ACID BINDING RESINS
bile binding resins can reduce LDL-C by 15 - 30% and increase..... HDL up to 5%...because of removal of bile acids, liver cells compensate by increasing metabolism of cholesterol to broduce more bile acids, resulting in a net reduction in total cholesterol levels......(drugs are Cholestyramine, Colestipol, Colesevelam)
HMG-CoA reductase drugs are aka?
Statins
the PRIMARY meds. used to lower elevated cholesterol levels are?
Bile Acid Binding Resisn, Niacin, Ezetimibe, and the Statins...
Hyperlipidemia
a primary cause of atherosclerosis is abnormal elevated levels of cholesterol and triglycerides in blood
Omacor
Omega-3 fatty acids 1st of new class agents used to reduce atherosclerosis...referred to as fish oils... it reduces the synthesis of triglyserides in the LIVER...it can also be used w/ Statins to further lower cholesterol
Lipoproteins
once the above is absorbed from teh GI tract, fats, (lipids), triglycerides, and cholesterol are bound to these circulating proteins
Triglycerides
body converts excess dietary carbs. to this....( a precursor of cholesterol) and dietary fat into cholesterole
the probability that atherosclerosis will develope relates directly to the concentration of what?
LDL
BILE ACID BINDING RESINS uess?
the drugs (3 above) may also be usd w/ statins to further lower LDL-C
Metabolic Syndrome
most common name for the Insulin Resistance Syndrome...African Americans have the lowest rates and Mexican Americans have the highest rates
FIBRIC ACIDS uses?
most effective triglyceride lowering agent, these must be used w/ caution in combo w/ STATINs...due to risk of myopathy and rhabdomyolysis
pT'S WHO TAKE BILE ACID SQUESTERING RESINS MAY REQUIRE SUPPLEMANTAL VITAMINS....what are they?
fat solualbe A,D, E, K...these may become deficient w/ LT use
Drug Class: Misc Antilipemic Agents
( ezmtimibe is the ddrug)1st of new class used to reduce atherosclerosis,,,,this acts on small intestine to inhibit absorption of cholesterol present in sm intestine that derives from cholesterol secreted in bile and from diet
IHMG--CoA Reductase Inhibitors DRUG interacgtions?
Niacin, Verapamil, Ranolazine, Cyclosporine, Itraconazole, Ketoconazole, Fluconazole, Propranolo, Rifampin, Warfarin, GRAPEFRUIT JUICE
STATINS are used for?
most potent and highly effective in lowering LDL
Lipoproteins are divided into 5 classes
Chylomicrons, Very Low Density Lipoproteins (VLDL's), Intermediate Density Lipoproteins (IDL's), Low Density Lipoproteins (LDL's) and High Density Lipoproteins (HDL's)

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