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82 Cards in this Set
- Front
- Back
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Three types of lipids
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triglycerides, phospholipids, steroids (sterols)
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Triglycerides are an _______ and account for ____% of total lipids in the body
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energy source; 90%
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Phospholipids are essential in building ______
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plasma membranes
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Best-known phospholipid are ____
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lechitins
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Most widely know sterol
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cholesterol
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_______ is a natural and vital component of plasma membranes
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Cholesterol
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Steroids (sterols) are necessary for the production of ________
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Vitamin D, bile acids, cortisol, estrogen and testosterone
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Sterols are not necessary in _____
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the diet
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Protein carrier is known as ______
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apoprotein
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Three types of apoproteins:
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high-density lipoprotein (HDL), low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL
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LDL transports
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cholesterol from the liver to tissues and organs
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________ carries the highest amount of cholesterol
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LDL
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LDL is known as ________
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bad cholesterol
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VLDL is the primary carrier of ______
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triglyercides in blood
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HDL is manufactured in the ________
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liver and small intestines
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HDL assist in transport of _______
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cholesterol away from body tissues and back to the liver
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HDL transports
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cholesterol for destruction
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_____ is know as good cholesterol
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HDL
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Lifestyle changes required to lower lipid levels include: Monitoring ______, maintaining _________, reducing ________ and _________ and increasing _______
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monitor blood-lipid level
maintain weight; exercise reduce dietary saturated fat and cholesterol and reducing or eliminating tobacco use increase soluble fiber |
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The goal of hyperlipidemics is ________
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to prevent hear disease in patient with high cholesterol and to maintain a cholesterol level of below 200 mg/dL
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5 classifications of hyperlipidemics
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fibric acid derivatives
HMG-CoA reductase inhibitors (statins) Niacin (nicotinic acid) Bile acid resin/binding agents Cholesterol absorption inhibitor |
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Fibric acid derivatives increase _____
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the secretion of cholesterol into bile
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Fibric acid derivatives activate
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lipase which breaks down fat
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Fibric acid derivatives reduces _______
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the synthesis of triglycerides in the liver
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Fibric acids decrease _____ and increase _______
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decrease VLDL and LDL
Increase HDL |
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Side effects of fibric acid:
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neasea, bloating, flatulence, diarrhea, liver changes
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drug of choice for treating severe hypertriglyceridemia
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fibric acid agents
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Fibric acid prototype:
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gemfibrozil (lopid)
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Mechanism of action of gemfibrozil (lopid)
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unknown
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Primary use of gemfibrozil (Lopid)
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treating sever hypertriglyercidemia
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Adverse effects of gemfibrozil (Lopid)
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GI distress, watch for bleeding with clients on anticoagulants
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What is HMG-CoA reductase?
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an enzyme used by the liver to produce cholesterol
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Inhibiting HMG-CoA lowers _____
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the rate of cholesterol production
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Adverse effects of HMG-CoA Inhibitors
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muscle pain, weakness or malaise
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What type of drug is tetrogenic?
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Statins (pregnancy category x)
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Side effects of statins (HMG-CoA reductase inhibitors)
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liver changes, GI upset, constipation or diarrhea, PHOTOSENSITIVITY
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Prototype for HMG-CoA reductase inhibitors/statins
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atorvastatin (Lipitor)
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Mechanism of action of atorvastatin (Lipitor)
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inhibits HMG-CoA reductase (enzyme used by the liver to produce cholesterol)
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Primary use of atorvastatin (Lipitor)
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reduce serum-lipid levels
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Adverse effects of atorvastatin (Lipitor)
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headache, fatigue, muscle or joint pain, and heartburn
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When should statins be administered and why?
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administered in evening because cholesterol synthesis is between midnight and 3 am
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Dietary requirements for statin recipients:
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increase water to 2,000-3,000 L/day
Increase fiber |
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Should statins be administered with or without meals?
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with meals to decrease GI irritability
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Patients taking statins should report unexplained _______
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muscle pain, weakness, malaise, jaundice or vision changes
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When should HMG-CoA reductace inhibitors be stopped?
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if LFT's show transaminase levels 3 times upper limit of normal
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Nurses should monitor ______ with patient taking statins
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LFT (liver function test)
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Do not use statins with ______
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pregnancy or breast-feeding
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With statins, watch for signs of ______
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GI upset
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Niacin is a _______
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b-complex vitamin
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Niacin does what to lipid levels?
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decreases VLDL and LDL levels
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Effects of Niacin are:
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decreases triglycerides and increases HDL
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Advantage of taking Niacin
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effective and inexpensive
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Niacin can be used in combination with ________
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other lipid-lowering agents
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Nicotinic Acid prototype
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Niacin (B3)
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Mechanism of action of Niacin
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to decrease VLDL levels
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Primary use of Niacin
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to reduce triglycerides and increase HDL levels
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Adverse effects of Niacin:
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flushing, hot flashes, nausea, excess gas, diarrhea, HYPOtension from vasodilation
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Dose of Niacin is _____
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1-2 grams TID
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Side effects of Niacin
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GI irritation, pruritis, flushing, HYPOtension from vasodilation
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Hypotension with Niacin occurs
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within 20 minutes of administration
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Action of bile acid resins
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combine with bile acids and form insoluble complexes that are excreted in feces
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Bile acid resins prevent _______
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resorption of bile acids from small intestines
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bile acid - binding resins bind with bile acids to increase ______
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excretion of cholesterol in stool
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Bile acid resins are used in combination with
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statins
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Uses for bile acid - binding resins ______
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decrease triglyceride levels and increase HDL by as much as 25%
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patients taking bile acid resins have an increased risk for ______
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gallstones
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side effects of bile acid resins
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abdominal discomfort, diarrhea or constipation, nausea, headache, prolonged PT
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what can bile acid resins do to the liver?
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cause dysfunctional changes and elevate enzymes
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Prototype for bile-acid resins
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cholestyramine (Questran)
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cholestyramine (Questran) mechanism of action
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bind with bile acids
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Primary use of cholestyramine (Questran)
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to lower serum-lipid levels
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bile acid resins have an administration alert.... why?
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can bind with other drugs, increasing potential for drug interactions
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bile acid resins should be administered how?
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medication (powder) must be mixed with liquid or soft food
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bile acid resins MUST NOT BE administered
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with other meds -
administer 1 hour before or 4 hours after other PO meds |
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Hyperlipidemics take _______ to show effectiveness
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several weeks
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With hyperlipidemics, labs should demonstrate ________
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lower cholesterol levels within 1 month
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With patients on hyperlipidemics, nurses should monitor ______, provide __________ and assess ___________
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monitor client's condition
provide education on prescribed medications assess client's triglyceride, total cholesterol, LDL and HDL levels |
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Nurses should take a thorough health assessment of _________ with patients on hyperlipidemics
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*dietary patterns
*exercise *family history (genetics, tobacco, alcohol use) *meds |
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Contraindications of Hyperlipidemics
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bilary obstruction, active liver disease
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Nurse should have ______ ordered before starting hyperlipidemics
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Labs - LFT's
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long term therapy of hyperlipidemics require
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supplemental fat soluble vitamins (A,D, E & K)
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Patients taking hyperlipidemics should report serious adverse effect such as ______
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visual changes or muscle pain
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