NUR354 Exam 3 Study Guide
Hyperlipidemia
Lipid Panel - Total cholesterol <200
- Triglycerides <150
- LDL <100
- “Bad” cholesterol
- HDL >50 in females and >40 in males
- “Good” cholesterol
Notes 1st Line Tx: Lifestyle Modifications
- Decrease saturated fats and cholesterol
- Increase dietary fiber
- Increase exercise
- Quit smoking
- Reduce weight
*Decision to start pharmacotherapeutics is based on LDL and sometimes the
Atherosclerotic Cardiovascular Disease Risk Factor (ASCVD)
- Guidelines on how to treat someone w/ hyperlipidemia
- Tells about baseline risk of developing an adverse cardiac event (heart
attack and stroke) in the next 10 years
- Tells whether or NOT putting a pt on a cholesterol med will help the pt
*Niacin is NO longer recommended for hyperlipidemia
- Has excessive SE
- An NSAID would be given to control SE
HMG-CoA Reductase Drugs:
Inhibitors (Statins) - Atorvastatin (Lipitor)
- Rosuvastatin (Crestor)
*1st line tx for hyperlipidemia - Simvastatin (Zocor)
MOA: inhibits HMG-CoA reductase = REDUCED LDL
*NOT recommended in Indications: hyperlipidemia and prevention of cardiovascular disease
pregnancy (based on risk
versus benefit) *Preferred to be taken in the evening due to cholesterol synthesis
- If already on it ->
stay on it SE/AE: hepatotoxicity, muscle aches that can progress to rhabdomyolysis
severe muscle pain ,
*Dose categorization: weakness dark urine
- High dose statin reduces LDL by around 50%
- Medium dose statin reduces LDL by around 30%-50%
- Low dose statin reduces LDL by around 30%
Bile Acid Sequestrants Drugs:
- Cholestyramine
- Colesevelam
MOA: increases loss of LDLthrough the feces
Indications: hyperlipidemia
SE/AE: GI effects
Pt Education: take an hour BEFORE or several hours AFTER other medications
, Cholesterol Absorption Drug:
Inhibitors - Ezetimibe (Zetia)
MOA: inhibits absorption of cholesterol
*Mainly used as an ADD on tIndications:
o hyperlipidemia
statin therapy SE/AE: nasopharyngitis
- Off label for cardiovascular disease prevention
Fibrates Drugs:
- Fenofibrate
*May be associated w/ right - Gemfibrozil (Lopid)
upper quadrant pain MOA: lowers VLDL (triglycerides)
Indications: hypertriglyceridemia
*Take w/ food SE/AE: INCREASED risk of gallstones
*Primarily lowers VLDL
*Go to drug when a pt does NOT have uncontrolled diabetes BUT has ISOLATED
triglycerides
PCSK9 Inhibitors Drugs:
- Alirocumab (Praluent)
*Used as an alternative agent - Evolocumab (Repatha)
for monotherapy in pts that MOA: prevents breakdown of LDL receptors for more LDL receptors to be working
can NOT tolerate statins to reduce LDL
Indications: Hyperlipidemia, prevention of cardiovascular disease
*INCREASED infection risk
*Given by subcutaneous injection
- Dosed every two or more weeks
Hyperlipidemia
Lipid Panel - Total cholesterol <200
- Triglycerides <150
- LDL <100
- “Bad” cholesterol
- HDL >50 in females and >40 in males
- “Good” cholesterol
Notes 1st Line Tx: Lifestyle Modifications
- Decrease saturated fats and cholesterol
- Increase dietary fiber
- Increase exercise
- Quit smoking
- Reduce weight
*Decision to start pharmacotherapeutics is based on LDL and sometimes the
Atherosclerotic Cardiovascular Disease Risk Factor (ASCVD)
- Guidelines on how to treat someone w/ hyperlipidemia
- Tells about baseline risk of developing an adverse cardiac event (heart
attack and stroke) in the next 10 years
- Tells whether or NOT putting a pt on a cholesterol med will help the pt
*Niacin is NO longer recommended for hyperlipidemia
- Has excessive SE
- An NSAID would be given to control SE
HMG-CoA Reductase Drugs:
Inhibitors (Statins) - Atorvastatin (Lipitor)
- Rosuvastatin (Crestor)
*1st line tx for hyperlipidemia - Simvastatin (Zocor)
MOA: inhibits HMG-CoA reductase = REDUCED LDL
*NOT recommended in Indications: hyperlipidemia and prevention of cardiovascular disease
pregnancy (based on risk
versus benefit) *Preferred to be taken in the evening due to cholesterol synthesis
- If already on it ->
stay on it SE/AE: hepatotoxicity, muscle aches that can progress to rhabdomyolysis
severe muscle pain ,
*Dose categorization: weakness dark urine
- High dose statin reduces LDL by around 50%
- Medium dose statin reduces LDL by around 30%-50%
- Low dose statin reduces LDL by around 30%
Bile Acid Sequestrants Drugs:
- Cholestyramine
- Colesevelam
MOA: increases loss of LDLthrough the feces
Indications: hyperlipidemia
SE/AE: GI effects
Pt Education: take an hour BEFORE or several hours AFTER other medications
, Cholesterol Absorption Drug:
Inhibitors - Ezetimibe (Zetia)
MOA: inhibits absorption of cholesterol
*Mainly used as an ADD on tIndications:
o hyperlipidemia
statin therapy SE/AE: nasopharyngitis
- Off label for cardiovascular disease prevention
Fibrates Drugs:
- Fenofibrate
*May be associated w/ right - Gemfibrozil (Lopid)
upper quadrant pain MOA: lowers VLDL (triglycerides)
Indications: hypertriglyceridemia
*Take w/ food SE/AE: INCREASED risk of gallstones
*Primarily lowers VLDL
*Go to drug when a pt does NOT have uncontrolled diabetes BUT has ISOLATED
triglycerides
PCSK9 Inhibitors Drugs:
- Alirocumab (Praluent)
*Used as an alternative agent - Evolocumab (Repatha)
for monotherapy in pts that MOA: prevents breakdown of LDL receptors for more LDL receptors to be working
can NOT tolerate statins to reduce LDL
Indications: Hyperlipidemia, prevention of cardiovascular disease
*INCREASED infection risk
*Given by subcutaneous injection
- Dosed every two or more weeks
