Antilipemic Drugs - Med note PDF

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NR293 Pharmacology for Nursing Practice Pharmacology Notes: Drug Group Non-Pharmacology   

Eat better Lose weight First-line drug therapy for hypercholesterolemia but it’s the last resort

Nursing Implications •

Before beginning therapy, obtain a thorough health and medication history.

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Assess dietary patterns, exercise level, weight, height, vital signs, tobacco and alcohol use, and family history.

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Assess for contraindications, conditions that require cautious use, and drug interactions.

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Contraindications include biliary obstruction, liver dysfunction, and active liver disease.

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Obtain baseline liver function studies.

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Patients on long-term therapy may need supplemental fat-soluble vitamins (A, D, K).

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Refer to guidelines regarding administration times and meals.

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Atorvastatin (Lipitor) - Dosed once daily, usually with the evening meal or at bedtime to correlate with diurnal rhythm

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Counsel patient concerning diet and nutrition on an ongoing basis.

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Instruct patient on proper procedure for taking the medications.

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Powder forms must be taken with a liquid, mixed thoroughly but not stirred, and never taken dry.

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Other medications should be taken 1 hour before or 4 to 6 hours after meals to avoid interference with absorption.

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To minimize adverse effects of niacin, start on low initial dose and gradually increase it, and take with meals.

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Small doses of aspirin or NSAIDs may be taken 30 minutes before niacin to minimize cutaneous flushing.

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Provide teaching regarding use of NSAIDs and aspirin.

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Inform patients that these drugs may take several weeks to show effectiveness.

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Instruct patients to report persistent GI upset, constipation, abnormal or unusual bleeding, and yellow discoloration of the skin.

NR293 Pharmacology for Nursing Practice •

Instruct patients to immediately report any signs of toxicity, including muscle soreness or changes in urine color.

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Monitor for adverse effects, including increased liver enzyme studies.

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Monitor for therapeutic effects:

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Reduced cholesterol and triglyceride levels

Class Antilipemic Statins “statin”

Antilipemic

Examples

MOA

Indications

Lovastatin Pravastatin Simvastatin Atorvastatin Rosuvastatin

Reduces cholesterol

Cholestyramine

Reduce cholesterol

Bile Acid

Reduce cholesterol

Adverse Effects Rash HA Muscle pain (rhabdomyolysis) Hepatoxicity

Heartburn Nausea Belching Bloating Constipation

Flushing (caused

Contraindications Hypersensitivity Interactions: Grapefruit juice

Interactions: All drugs must be taken at least 1 hour before or 4 to 6 hours after the administration of bile acid sequestrants. High doses of a bile acid ↓ the absorption of fatsoluble vitamins (ADEK)

Nursing Implications Monitor renal function Monitor cholesterol

↑ fiber in diet Take Metamucil (Mix well with 8 oz of H2O), and ↑ fluid intake. Substitute supplement vitamins

NR293 Pharmacology for Nursing Practice Niacin B3 (Nicotinic Acid)

Fibric Acid Derivatives “fib”

Class

Gemfibrozil Fenofibrate

Examples

Treatment of hyperlipidemias

MOA

by histamine release -itching) Pruritus GI distress -you can give NSAID drugs for the itching. Abdominal discomfort N/D Blurred vision HA ↑ risk of gallstones Prolonged prothrombin time

Pharmacology Notes: Drug Group Indications Adverse Effects

Hypersensitivity Liver or kidney disease Cirrhosis Gallbladder disease Interactions Statins Oral anticoagulants

Contraindications

Nursing Implications

NR293 Pharmacology for Nursing Practice...